Radboud University Nijmegen Medical Centre, Nijmegen Centre for Evidence Based Practice, Department of Rehabilitation, Nijmegen, The Netherlands.
Dev Med Child Neurol. 2013 Jan;55(1):76-82. doi: 10.1111/j.1469-8749.2012.04442.x. Epub 2012 Oct 24.
To investigate the validity and reliability of the revised Video-Observation Aarts and Aarts module: Determine Developmental Disregard (VOAA-DDD-R).
Upper-limb capacity and performance were assessed in children with unilateral spastic cerebral palsy (CP) by measuring overall duration of affected upper-limb use and the frequency of specific behaviours during a task in which bimanual activity was demanded ('stringing beads') and stimulated ('decorating a muffin'). Developmental disregard was defined as the difference in duration of affected upper-limb use between both tasks. Raters were two occupational and one physical therapist who received 3 hours of training. Construct validity was determined by comparing children with CP with typically developing children. Intrarater, interrater, and test-retest reliability were determined using the intraclass correlation coefficient. Standard errors of measurement and smallest detectable differences were also calculated.
Twenty-five children with CP (15 females, 10 males; mean age 4 y 9 mo [SD 1 y 7 mo], range 2 y 9 mo-8 y; Manual Ability Classification System levels I-III) scored lower on capacity (p=0.052) and performance (p<0.001), and higher on developmental disregard (p<0.001) than 46 age- and sex-matched typically developing children (23 males; mean age 5 y 3 mo [SD 1 y 5 mo], range 2 y 6 mo-8 y). The intraclass correlation coefficients (0.79-1.00) indicated good reliability. Absolute agreement was high, standard errors of measurement ranged from 4.5 to 6.8%, and smallest detectable differences ranged from 12.5 to 19.0%.
The VOAA-DDD-R can be reliably and validly used by occupational and physical therapists to assess upper-limb capacity, performance, and developmental disregard in children (2 y 6 mo-8 y) with CP.
研究修订后的视频观察 Aarts 和 Aarts 模块的有效性和可靠性：确定发育忽视（VOAA-DDD-R）。
通过测量单侧痉挛性脑瘫（CP）儿童在需要双手活动的任务（串珠）和受刺激的任务（装饰松饼）中受影响上肢使用的总持续时间以及特定行为的频率，评估上肢能力和表现。发育忽视被定义为两个任务中受影响上肢使用持续时间的差异。评估者为 2 名职业治疗师和 1 名物理治疗师，他们接受了 3 小时的培训。通过比较 CP 儿童和正常发育儿童来确定结构有效性。使用组内相关系数确定内部评估者、外部评估者和测试-重测可靠性。还计算了测量标准误差和最小可检测差异。
25 名 CP 儿童（15 名女性，10 名男性；平均年龄 4 岁 9 个月[SD 1 岁 7 个月]，范围 2 岁 9 个月-8 岁；手动能力分类系统 1-3 级）在能力（p=0.052）和表现（p<0.001）方面得分较低，而在发育忽视（p<0.001）方面得分较高，与 46 名年龄和性别匹配的正常发育儿童（23 名男性；平均年龄 5 岁 3 个月[SD 1 岁 5 个月]，范围 2 岁 6 个月-8 岁）相比。组内相关系数（0.79-1.00）表明可靠性良好。绝对一致性很高，测量标准误差范围为 4.5%至 6.8%，最小可检测差异范围为 12.5%至 19.0%。
职业治疗师和物理治疗师可以使用 VOAA-DDD-R 可靠且有效地评估患有 CP 的儿童（2 岁 6 个月-8 岁）的上肢能力、表现和发育忽视。
