Kembe Johanna, Holmström Linda, Broström Eva, Sundelin Heléne, Eliasson Ann-Christin
Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.
Theme Women's Health and Allied Health Professionals, Medical Unit Allied Health Professional, Karolinska University Hospital, Stockholm, Sweden.
Dev Med Child Neurol. 2025 Oct;67(10):1301-1308. doi: 10.1111/dmcn.16318. Epub 2025 Apr 4.
To evaluate the concurrent validity and interrater reliability of remote screening Hand Assessment for Infants (s-HAI) in infants aged 3.5 to 12 months at risk of unilateral cerebral palsy (CP), and to assess the feasibility of parents administering and recording the s-HAI play session using a smartphone app.
In this observational study, 30 infants (10 females) at risk of unilateral CP were assessed with remote s-HAI, administered by their parents, and compared with the HAI conducted in a clinical setting. The quality of the s-HAI recordings was assessed and parents' experiences were collected using a questionnaire. The Spearman's rank correlation coefficient (r) was calculated for the Each Hand Sum score of s-HAI and the corresponding six-item HAI. The interrater reliability of the s-HAI recordings was calculated using the intraclass correlation coefficient.
Parents recorded the s-HAI play session with good quality and found it feasible. A strong correlation of r = 0.86 (p < 0.001) was found between the s-HAI and the six-item HAI. Interrater reliability was 0.96 (95% confidence interval [CI] = 0.92-0.99) for the affected hand, 0.95 (95% CI = 0.90-0.98) for the non-affected hand, and moderate to excellent for individual items.
The s-HAI measures the same construct as the six-item HAI, demonstrating reliable scoring between raters when administered remotely by parents, making the s-HAI a viable tool for the early identification of infants at risk of unilateral CP.
评估针对3.5至12个月有单侧脑瘫（CP）风险婴儿的远程筛查婴儿手部评估（s-HAI）的同时效度和评分者间信度，并评估父母使用智能手机应用程序管理和记录s-HAI游戏环节的可行性。
在这项观察性研究中，对30名有单侧CP风险的婴儿（10名女性）进行了由其父母管理的远程s-HAI评估，并与在临床环境中进行的HAI进行比较。评估了s-HAI记录的质量，并通过问卷收集了父母的体验。计算了s-HAI的每只手总分与相应的六项HAI的斯皮尔曼等级相关系数（r）。使用组内相关系数计算s-HAI记录的评分者间信度。
父母高质量地记录了s-HAI游戏环节，并认为其可行。s-HAI与六项HAI之间的相关性很强，r = 0.86（p < 0.001）。患侧手的评分者间信度为0.96（95%置信区间[CI] = 0.92 - 0.99），非患侧手为0.95（95% CI = 0.90 - 0.98），各单项为中度至优。
s-HAI与六项HAI测量的是相同的结构，表明当由父母远程管理时，评分者之间的评分可靠，这使得s-HAI成为早期识别有单侧CP风险婴儿的可行工具。
