Observational skills assessment score: reliability in measuring amount and quality of use of the affected hand in unilateral cerebral palsy

Abstract

BackgroundThe Observational Skills Assessment Score (OSAS) measures amount and quality of use of the affected hand in children with unilateral Cerebral Palsy (CP) in bimanual activities and could therefore be a valuable addition to existing assessment tools. The OSAS consists of tasks that are age appropriate and require use of the affected hand.MethodsTo measure the agreement and reliability of the OSAS a convenience sample of two groups of 16 children with unilateral spastic CP (2.5-6 and 12–16 years old), performed age specific bimanual tasks in 2 measurement sessions. Three experienced raters took part in testing and 8 in scoring. Intra class correlation (ICC) values for intra- and inter-rater reliability, and the mean and standard deviation of the differences between measurements were calculated. For test-retest reliability beside ICC scores, Smallest Detectable Differences (SDDs) were calculated in 16 older and 10 younger children.ResultsGenerally, there seems to be good agreement between repeated measurements of the OSAS, as indicated by the small SDDs on most scales for quality of movement, compared to the range of their scales. This indicates potentially good sensitivity to change if used for patient evaluation purposes. The exceptions were the ‘quality of reach’ score for all tasks, and all quality scores for the stacking blocks task for the young children. As used in the present study, the OSAS has good discriminative capacity within patient populations as indicated by the high ICCs for most quality scores. Measuring the amount of use does not seem to be useful for either discrimination or evaluation.ConclusionIn general, the OSAS seems to be a reliable tool for assessing the quality of use of the affected hand in bimanual activities in younger and older children with unilateral CP. Some modifications may improve its usefulness and efficiency.

Effects of botulinum toxin A and/or bimanual task-oriented therapy on upper extremity activities in unilateral Cerebral Palsy: a clinical trial

“…In the younger children this effect lasted even longer. Given that the known smallest detectable differences of the quality of grasp and hold wrist scores in these tasks vary from 0.34 to 0.87, the found differences are substantial [ 18 ].…”

“…Both the AHA (a video assessment) and the AK (a questionnaire) were performed to measure effectiveness of use of the affected hand (AH) in bimanual performance. To measure amount and quality of use of the AH i.e., capacity, the OSAS [ 18 ] was administered. The AHA and the OSAS were administered by a certified, experienced occupational therapist (OTst).…”

“…For this, the Observational Skills Assessment Score (OSAS) was developed and tested for its clinimetric properties. It appeared to be an appropriate instrument [ 18 ].…”

Reliability and Responsiveness of Upper Limb Motor Assessments for Children With Central Neuromotor Disorders

“…For test-retest reliability, the MHC, Quality of Upper Extremities Skills Test (QUEST), [28][29][30][31][32][33] UERS, Peabody Developmental Motor Scales-2-Fine Motor abilities (PDMS-2 FM), 41 VOAA-DDD-R, ABILHANDKids, 50 Münchner ADL-Fragebogen (M-ADL), 52 the PMAL "how often" scale, 53 and the Shriners Hospital for Children CP Computer-Adapted Testing battery-Upper Extremities 49 showed limited positive evidence. All other assessments (House-Classification, 21 Modified Ashworth Scale [MAS], [18][19][20] Mowery Classification, 21 47 and Accelerometry [25][26][27] ) were found to have unknown, conflicting, or negative levels of evidence for reliability (Table 2).…”

Left/right hand segmentation in egocentric videos

“…This is particularly true when it comes to understand bi-manual tasks [15,16], e.g. in medical rehabilitation of upper-limb stroke [17] and cerebral palsy [18]. Another field that can benefit from this independent understanding is neuroscience, where handdominance is commonly associated with several neurological factors [19].…”