Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Faculty of Health Science, Mälardalens University, Västerås, Sweden.
Dev Med Child Neurol. 2021 Dec;63(12):1456-1461. doi: 10.1111/dmcn.14967. Epub 2021 Jul 5.
To evaluate the interrater and test-retest reliability, standard error of measurement (SEM), and the smallest detectable difference (SDD) of the Hand Assessment for Infants (HAI).
HAI assessments of 55 infants (26 females, 29 males), 25 with clinical signs of unilateral cerebral palsy (CP) and 30 typically developing (mean [SD] age 6.8mo [2.4], range 3-11mo), were scored individually by three therapists. Three clinically experienced occupational therapists (OT 1-OT 3) with extensive experience in using the HAI, independently scored the video recorded HAI play sessions. Analysis of the combined group of infants and just the infants with clinical signs of unilateral CP (12 females, 13 males; mean age 7.6mo [2.1]) were conducted. Intraclass correlation coefficients (ICC, 2.1), Bland-Altman plots, SEM, and SDD were calculated.
Interrater and test-retest reliability were excellent for the Both Hands Measure (BoHM) and the Each Hand Sum score (EaHS), with ICCs of 0.96 to 0.99. For individual items, the interrater and test-retest reliability was good to excellent (ICC 0.81-0.99). The SDD for the EaHS was 2 points, and for the BoHM the SDD it was 3 HAI units for infants with signs of unilateral CP.
The HAI results showed good to excellent reliability. The SDDs were low, indicating that results beyond these levels exceed the measurement error and, thus, can be considered true changes. What this study adds The Hand Assessment for Infants (HAI) shows excellent reliability. A change of ≥3 HAI units is considered a true change. The HAI yields reliable measures for research and clinical practice.
评估 Hand Assessment for Infants（HAI）的评分者间信度、重测信度、测量标准误（SEM）和最小可检测差异（SDD）。
由 3 位治疗师分别对 55 名婴儿（女 26 名，男 29 名）进行 HAI 评估，其中 25 名婴儿有单侧脑瘫（CP）的临床症状，30 名婴儿为典型发育（平均[标准差]年龄 6.8 月龄[2.4]，范围 3-11 月龄）。3 位具有丰富 HAI 使用经验的临床经验丰富的作业治疗师（OT1-OT3）对视频记录的 HAI 游戏评估进行了独立评分。对合并组婴儿和仅具有单侧 CP 临床症状的婴儿（女 12 名，男 13 名；平均年龄 7.6 月龄[2.1]）进行了分析。计算了组内婴儿和仅具有单侧 CP 临床症状的婴儿的组内相关系数（ICC，2.1）、Bland-Altman 图、SEM 和 SDD。
Both Hands Measure（BoHM）和 Each Hand Sum score（EaHS）的评分者间信度和重测信度均极佳，ICC 为 0.96 至 0.99。对于个别项目，评分者间信度和重测信度为良好至极佳（ICC 0.81-0.99）。EaHS 的 SDD 为 2 分，单侧 CP 婴儿的 BoHM 的 SDD 为 3 HAI 单位。
HAI 结果显示出良好至极佳的可靠性。SDD 较低，表明超过这些水平的结果超出了测量误差，因此可以被认为是真实的变化。本研究的新增内容 Hand Assessment for Infants（HAI）显示出极佳的可靠性。变化≥3 HAI 单位被认为是真实的变化。HAI 为研究和临床实践提供了可靠的测量结果。
