The University of Queensland, Faculty of Medicine, Queensland Cerebral Palsy and Rehabilitation Centre, South Brisbane, Australia.
The University of Queensland, School of Health and Rehabilitation Sciences, Brisbane, Australia.
Phys Occup Ther Pediatr. 2021;41(4):358-371. doi: 10.1080/01942638.2020.1856286. Epub 2020 Dec 17.
To describe bimanual performance in a sample of Australian children with bilateral cerebral palsy (CP) and, examine the qualitative meaning (or interpretability) of scores on the Both Hands Assessment (BoHA).
Children with bilateral CP aged 8-12 years ( = 54) classified Manual Ability Classification System (MACS) level I = 20, II = 18, III = 16 were examined using the BoHA.
Bimanual performance was significantly different across MACS levels I-III ( < 0.001). Mean (95%CI) BoHA-unit for each MACS level were I = 85 (81-89), II = 72 (68-76) and III = 53 (49-56). Children with asymmetrical hand use (≥ 20% difference between upper limbs, n = 10) were classified MACS levels II and III and had a mean (95%CI) BoHA-unit of 56 (51-62). Children with symmetrical hand use were classified in MACS level I-III and had a mean (95%CI) BoHA-unit of 74 (70-79).
The BoHA quantified observations of bimanual performance for children with bilateral CP, differentiated between MACS levels I-III and provided clinically meaningful information. The BoHA may facilitate tailoring of upper limb intervention. Future research is recommended to examine inter-rater and intra-rater reliability and responsiveness of the BoHA, as well as longitudinal studies of bimanual hand skill development in children with bilateral CP.
描述澳大利亚双侧脑瘫（CP）儿童样本的双手表现，并探讨双手评估（BoHA）评分的定性意义（或可解释性）。
对 8-12 岁双侧 CP 儿童（n=54）进行评估，根据手动能力分类系统（MACS）分为 I 级=20，II 级=18，III 级=16。
MACS 水平 I-III 之间的双手表现差异具有统计学意义（<0.001）。每个 MACS 水平的平均（95%CI）BoHA 单位分别为 I=85（81-89），II=72（68-76）和 III=53（49-56）。有非对称手使用（上肢之间差异≥20%，n=10）的儿童被归类为 MACS 水平 II 和 III，BoHA 单位的平均值（95%CI）为 56（51-62）。有对称手使用的儿童被归类为 MACS 水平 I-III，BoHA 单位的平均值（95%CI）为 74（70-79）。
BoHA 量化了双侧 CP 儿童的双手表现，区分了 MACS 水平 I-III，并提供了有临床意义的信息。BoHA 可能有助于定制上肢干预措施。建议进行未来研究，以检验 BoHA 的评定者间信度、评定者内信度和反应度，以及双侧 CP 儿童双手技能发展的纵向研究。
