Reliability of the Melbourne Assessment of Unilateral Upper Limb Function

Randall, Melinda; Chondros, Patty; Reddihough, Dinah

doi:10.1111/j.1469-8749.2001.tb00158.x

Cited by 105 publications

(155 citation statements)

References 8 publications

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“…Selection is preferably based not only on literature, but also on discussions with experts in the field of HCP and tasks assessed in standardised clinical scales, e.g. the Melbourne Assessment [5], or the SHUEE [7].…”

Section: Discussionmentioning

confidence: 99%

Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

et al. 2009

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This review provides an overview of results found in literature on objective measurements of upper limb movements in children with hemiplegic cerebral palsy (HCP). Seventeen articles were selected following a systematic search. Analysed tasks varied from simple reaching and gross motor functions to complex, fine motor tasks. Spatiotemporal characteristics have been extensively studied and longer movement durations, slower movement speed and reduced trajectory straightness at the affected upper limb, compared to the non-affected side or healthy children, were most frequently reported. Joint kinematics has been far less studied. The limited data confirm the clinical impression of children with HCP using less elbow extension and supination to reach for an object, which is compensated by increased trunk flexion. Increased trunk involvement was also reported during gross motor functions. Although three-dimensional (3D) movement analysis seems promising to provide additional insights in the pathological upper limb movements observed in HCP, future standardisation of the entire protocol is crucial. No consensus exists on the procedures for data collection, processing, analysing and reporting of results, or what upper limb tasks should be assessed. The International Society of Biomechanics recently proposed recommendations on the definition of upper limb joint coordinate systems and rotation sequences. These guidelines were not yet applied in these studies. Although the diverse methodological approaches used in the studies complicate the comparison of published results, some general conclusions could be drawn. A further standardisation of the protocol for 3D upper limb movement analysis will provide the foundation for comparable and repeatable results and eventually facilitate the selection and planning of treatment interventions.

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Section: Discussionmentioning

confidence: 99%

Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

et al. 2009

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“…Fine motor functions were measured with the Melbourne Assessment of Unilateral Upper Limb Function [18] (Melbourne Assessment), a criterionreferenced test with established validity and reliability for assessing the quality of upper limb fine motor function. The 16 items involving reaching, grasping, releasing and manipulation were scored by the research occupational therapist from the videotape.…”

Section: Melbourne Assessment Of Unilateral Upper Limb Functionmentioning

confidence: 99%

Upper limb function after botulinum toxin A treatment in cerebral palsy: Two years follow-up of six cases

Sätilä

Kotamäki

Koivikko

et al. 2006

Pediatric Rehabilitation

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The objective of this study was to investigate the effects of botulinum toxin A (BTXA) treatment on impairment and function of the upper limb during a 2-year follow-up period. A prospective longitudinal study design with assessments before and after intervention was utilized, involving six patients with cerebral palsy (three boys and three girls) aged 3 years 4 months to 11 years 11 months at commencement of study. The outcome measures were spasticity (modified Ashworth, MAS), active and passive range of movement (ROM), grips (pinch, key grip, 3-finger grip, narrow cylinder grip, wide cylinder grip, pen grip and diagonal grip; grasping, releasing; pronation-supination), bimanual functions, fine motor functions (Melbourne Assessment of Unilateral Upper Limb Function), movement pattern (Upper Limb Physician's Rating Scale, ULPRS), functional skills and self-care capability (Paediatric Evaluation of Disability Inventory, PEDI), upper extremity use (House Classification) and cosmetic appearance. The assessments were repeated by the same examiners at baseline and at 1, 3 and 6 months after each BTXA treatment and then every 6 months until 24 months. One subject received a total of four injections (at 0, 6, 12 and 18 months), one two injections (at 0 and 12 months) and four one injection at the beginning of the study period. Upper extremity surgery was performed on two subjects during the study and one was operated on 2 months after completion of the study. All children benefited from the BTXA treatment in terms of reduction in muscle tone and increase in active and passive ROM. By 6 months, spasticity returned, but in four children passive and especially active ROM remained better than at baseline. No significant changes in grips, bimanual tasks or Melbourne Assessment scores were detected. The change in movement pattern (ULPRS) was maintained for 3 months in two children and beyond this in four, thus extending beyond the pharmacologic effects of botulinum toxin A. All but one child showed improvement in PEDI functional skill and caregiver assistance scale scores during the 2-year period. The House classification showed a one-grade improvement in one child at 1 month and in one child at 3 months and a three-grade improvement in one child at 3 months after BTXA treatment. After each treatment, the parents reported at least a one-grade improvement in cosmetic appearance in all children at 1 month and in four children maintained at least until 6 months. In two subjects operated during the study period, a distinct improvement in active and passive ROM and a two-grade improvement in the House classification were observed after the operation. In this limited series, the reduction in muscle tone after BTXA treatment did not translate into better gripping or quality of fine motor functions (Melbourne Assessment) of the affected hand, but seemed to have a positive effect on upper limb movement pattern (ULPRS), upper extremity use (House Classification) and cosmetic appearance. Assessment of upper limb function in a child with ...

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“…Frequently used clinical measures, such as passive range of motion [5,6], measurement of muscle tone [7] and even classification of types of cerebral palsy have all shown poor reproducibility between observers and sessions, even when tested under standardised conditions [8]. Two the cerebral palsy population [9,10]. However, both of these measures rely on the therapist making a subjective visual assessment of the child's range and quality of upper limb movement.…”

Section: Introductionmentioning

confidence: 98%

Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia

et al. 2005

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Reliability of the Melbourne Assessment of Unilateral Upper Limb Function

Cited by 105 publications

References 8 publications

Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

Review of quantitative measurements of upper limb movements in hemiplegic cerebral palsy

Upper limb function after botulinum toxin A treatment in cerebral palsy: Two years follow-up of six cases

Reliability of upper and lower limb three-dimensional kinematics in children with hemiplegia

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