The Unilateral Below Elbow Test: a function test for children with unilateral congenital below elbow deficiency

Abstract

The Unilateral Below Elbow Test (UBET) was developed to evaluate function in bimanual activities for both the prosthesis wearer and non-wearer. Nine tasks were chosen for each of four age-specific categories defined by development stages of hand function (2-4y, 5-7y, 8-10y, and 11-21y). Two scales, Completion of Task and Method of Use, were designed to rate performance. To measure reliability, four occupational therapists scored samples of videotaped UBET performances. For Completion of Task, an interval scale, agreement in scoring was measured with interclass correlation coefficients (ICC; n=9; five females, four males). For Method of Use, a nominal scale, chance-adjusted association was calculated with Cohen's kappa coefficients (interobserver n=198; 111 females, 87 males; intraobserver n=93; 56 females, 37 males). For Completion of Task, the average ICC was 0.87 for the prosthesis-on condition, and 0.85 for the prosthesis-off condition. ICCs exceeded 0.80 for eight out of nine tasks for the two older age groups, but for only five out of nine tasks in the younger age groups. Higher inter- and intraobserver kappa coefficients for Method of Use resulted when scoring children with their prostheses on versus off. The oldest age group had lower kappa values than the other three groups. The UBET is recommended for the functional evaluation of Completion of Task in children with unilateral congenital below elbow deficiency with and without their prostheses. Method of Use scoring can evaluate individuals for directed therapy interventions or prosthetic training.

Test-retest reliability and rater agreements of Assessment of Capacity for Myoelectric Control version 2.0

“…This is partly because only a handful of outcome measures have been validated with upper-limb prosthesis users [6] and partly due to the difficulty in recruiting users for the retest session because many of them do not live near the prosthetic clinics. Since the development of ACMC, two more outcome measures that measure prosthetic function have been developed [39][40] and test-retest reliability was also evaluated in these two measures [40][41]. The ICC that we obtained is similar to the ICC in one of the measures [40] and higher than the other outcome measure [41].…”

Use and functioning of the affected limb in children with unilateral congenital below-elbow deficiency during infancy and preschool age: A longitudinal observational multiple case study

“…Many studies have been performed to evaluate functioning in daily life of children with UCBED with or without prosthesis [1,2,6,[15][16][17][18]. However, our study is the first with a longitudinal and observational design starting in infancy.…”

“…It also shows the value of the short limb as an exploratory, manipulatory and fixating tool. Scoring within the norms of the PEDI does however not preclude the presence of more specific problems in daily life activities, for instance activities evaluated with the Unilateral Below Elbow Test (UBET) or the Prosthetic Upper extremity Functional Index (PUFI) [16,21]. The first test may be more suitable to evaluate the extent to which a child actually uses an affected limb for daily activities.…”

Influence of standardized activities on validity of Assessment of Capacity for Myoelectric Control

“…Some of these measures have a standard set of activities or tasks [23][24], whereas others have different activities for different age groups [25][26] or client-chosen activities [1]. Until now, those measures that have different activities [1,[25][26] have not been investigated with regard to whether the Note: All 60 × 3 ability measures (in logits) are arranged in descending order for each category of prosthesis wearing time. In bold are prosthesis users with >0.5 logits (2 raw scores) difference among their three ability measures.…”