Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Department of Occupational Therapy, College of Health and Rehabilitation Sciences: Sargent, Boston University, Boston, MA, USA.
Dev Med Child Neurol. 2023 Mar;65(3):385-392. doi: 10.1111/dmcn.15362. Epub 2022 Jul 22.
To examine the relationship between assisting hand use in bimanual activities and children's self-care activities and task performance.
We retrospectively analysed daily functioning (Pediatric Evaluation of Disability Inventory [PEDI]) and bimanual performance (Assisting Hand Assessment [AHA]) data from the assessment of 112 children (mean age: 8 years 10 months [SD 2 years 1 month], range 3 years 7 months-17 years 4 months; 66 males, 46 females) with unilateral spastic cerebral palsy (CP). We used Rasch analysis to examine the relationship between individual item scores from the AHA and the self-care items (functional skills, caregiver assistance) from the PEDI.
Most self-care functional skills and caregiver-assisted tasks were located on the middle of the unidimensional continuum. These items showed similar levels of difficulty as the items from the AHA related to the effective coordination of two hands, appropriate pace, and use of the assisting hand to stabilize and release objects, as well as variations in arm movements.
The distribution of the PEDI self-care and AHA items along the unidimensional continuum illustrates the relationship between assisting hand use and self-care bimanual performance. Interpretation of the items' locations on the hierarchical unidimensional continuum may be helpful to therapists' clinical reasoning and suggest intervention goals to improve the hand function and daily functioning of children with unilateral spastic CP. Such an application needs further investigation.
研究双手活动中辅助手的使用与儿童自理活动和任务表现之间的关系。
我们回顾性分析了 112 例单侧痉挛性脑瘫儿童（平均年龄：8 岁 10 个月[SD 2 岁 1 个月]，范围 3 岁 7 个月-17 岁 4 个月；66 名男性，46 名女性）的日常功能（残疾儿童评估量表[PEDI]）和双手表现（辅助手评估[AHA]）数据。我们使用 Rasch 分析来检查 AHA 中各单项得分与 PEDI 中自理项目（功能技能、照顾者协助）之间的关系。
大多数自理功能性技能和照顾者协助任务位于单维连续体的中间。这些项目与 AHA 中与双手有效协调、适当节奏、辅助手稳定和释放物体以及手臂运动变化相关的项目具有相似的难度水平。
PEDI 自理和 AHA 项目在单维连续体上的分布说明了辅助手使用与自理双手表现之间的关系。对项目在分层单维连续体上位置的解释可能有助于治疗师的临床推理，并为改善单侧痉挛性脑瘫儿童的手部功能和日常功能提出干预目标。这种应用需要进一步研究。
