The assisting hand assessment for children and youth with brachial plexus birth injury: a study of validity and item hierarchy of AHA-Plex

Authors

  • Marie Holmefur School of Health Sciences, Örebro University, Örebro, Sweden https://orcid.org/0000-0001-5418-3154
  • Ann-Kristin Gunnes Elvrum Clinic of Rehabilitation, St. Olav’s Hospital, Trondheim University Hospital, Trondheim, Norway and Department of Clinical and Molecular Medicine and Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
  • Lena Krumlinde-Sundholm Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden

DOI:

https://doi.org/10.2340/jrm.v55.15325

Keywords:

Assessment, hand function, brachial plexus birth injury, Rasch analysis, validity, AHA-Plex

Abstract

Objective: Functional assessments that focus on activity performance and that produce valid outcome measures for people with brachial plexus birth injury are lacking. The primary aim of this study was to re-evaluate the internal scale validity of the Assisting Hand Assessment specifically for children and adolescents with brachial plexus birth injury. Two further aims were investigating whether the scale could be shortened for this group while maintaining psychometric quality, and exploring and presenting its item difficulty hierarchy.

Design: A cross-sectional psychometric study.

Subjects: A convenience sample of 105 children and adolescents (aged 18 months to 18 years, mean 6 years, 7 months, standard deviation (SD) 4 years, 4 months) from Sweden, Norway, and the Netherlands with brachial plexus birth injury.

Methods: Participants were assessed with the Assisting Hand Assessment. Data were analysed with Rasch measurement analysis.

Results: The 20 Assisting Hand Assessment items together measured a unidimensional construct with high reliability (0.97) and the 4-level rating scale functioned well. Item reduction resulted in 15 items with good item fit, unidimensionality, reliability and acceptable targeting.

Conclusion: Assisting Hand Assessment for people with brachial plexus birth injury, called AHA-Plex, has 15 items and good internal scale validity. A unique item hierarchy for people with brachial plexus birth injury is presented.

Downloads

Download data is not yet available.

References

Zielinski IM, van Delft R, Voorman JM, Geurts ACH, Steenbergen B, Aarts PBM. The effects of modified constraint-induced movement therapy combined with intensive bimanual training in children with brachial plexus birth injury: a retrospective data base study. Disabil Rehabil 2021; 43: 2275-2284.

https://doi.org/10.1080/09638288.2019.1697381 DOI: https://doi.org/10.1080/09638288.2019.1697381

Hulleberg G, Elvrum AK, Brandal M, Vik T. Outcome in adolescence of brachial plexus birth palsy. 69 individuals re-examined after 10-20 years. Acta Orthop 2014; 85: 633-640.

https://doi.org/10.3109/17453674.2014.964614 DOI: https://doi.org/10.3109/17453674.2014.964614

Chang KW, Justice D, Chung KC, Yang LJ. A systematic review of evaluation methods for neonatal brachial plexus palsy: a review. J Neurosurg Pediatr 2013; 12: 395-405.

https://doi.org/10.3171/2013.6.PEDS12630 DOI: https://doi.org/10.3171/2013.6.PEDS12630

Werner JM, Berggren J, Loiselle J, Lee GK. Constraint-induced movement therapy for children with neonatal brachial plexus palsy: a randomized crossover trial. Dev Med Child Neurol 2021; 63: 545-551

https://doi.org/10.1111/dmcn.14741 DOI: https://doi.org/10.1111/dmcn.14741

Krumlinde-Sundholm L, Eliasson AC. Development of the Assisting Hand Assessment: a Rasch-built measure intended for children with unilateral upper limb impairments. Scand J Occup Ther 2003; 10: 16-26.

https://doi.org/10.1080/11038120310004529 DOI: https://doi.org/10.1080/11038120310004529

American Educational Research Association APANCoMiE. Standards for educational and psychological testing. Washington: American Educational Research Association, American Psychological Association, National Council on Measurement in Education; 2014.

Krumlinde-Sundholm L, Holmefur M, Kottorp A, Eliasson AC. The Assisting Hand Assessment: current evidence of validity, reliability and responsiveness to change. Dev Med Child Neurol 2007; 49: 259-264.

https://doi.org/10.1111/j.1469-8749.2007.00259.x DOI: https://doi.org/10.1111/j.1469-8749.2007.00259.x

Steenbergen B, Gordon AM. Activity limitation in hemiplegic cerebral palsy: evidence for disorders in motor planning. Dev Med Child Neurol 2006; 48: 780-783. DOI: https://doi.org/10.1111/j.1469-8749.2006.tb01367.x

https://doi.org/10.1017/S0012162206001666 DOI: https://doi.org/10.1017/S0012162206001666

Van der Looven R, Le Roy L, Tanghe E, Samijn B, Roets E, Pauwels N, et al. Risk factors for neonatal brachial plexus palsy: a systematic review and meta-analysis. Dev Med Child Neurol 2020; 62: 673-683.

https://doi.org/10.1111/dmcn.14381 DOI: https://doi.org/10.1111/dmcn.14381

Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl 2007; 109: 8-14.

Strömbeck C, Krumlinde-Sundholm L, Forssberg H. Functional outcome at 5 years in children with obstetrical brachial plexus palsy with and without microsurgical reconstruction. Dev Med Child Neurol 2000; 42: 148-157.

https://doi.org/10.1017/S001216220000027X DOI: https://doi.org/10.1017/S001216220000027X

Lagerkvist AL, Johansson U, Johansson A, Bager B, Uvebrant P. Obstetric brachial plexus palsy: a prospective, population-based study of incidence, recovery, and residual impairment at 18 months of age. Dev Med Child Neurol 2010; 52: 529-534.

https://doi.org/10.1111/j.1469-8749.2009.03479.x DOI: https://doi.org/10.1111/j.1469-8749.2009.03479.x

Pondaag W, Malessy MJ, van Dijk JG, Thomeer RT. Natural history of obstetric brachial plexus palsy: a systematic review. Dev Med Child Neurol 2004; 46: 138-144. DOI: https://doi.org/10.1111/j.1469-8749.2004.tb00463.x

https://doi.org/10.1017/S0012162204000258 DOI: https://doi.org/10.1017/S0012162204000258

Holmefur M, Krumlinde-Sundholm L. Psychometric properties of a revised version of the Assisting Hand Assessment (Kids-AHA 5.0). Dev Med Child Neurol 2016; 58: 618-624.

https://doi.org/10.1111/dmcn.12939 DOI: https://doi.org/10.1111/dmcn.12939

Louwers A, Beelen A, Holmefur M, Krumlinde-Sundholm L. Development of the Assisting Hand Assessment for adolescents (Ad-AHA) and validation of the AHA from 18 months to 18 years. Dev Med Child Neurol 2016; 58: 1303-1309.

https://doi.org/10.1111/dmcn.13168 DOI: https://doi.org/10.1111/dmcn.13168

Bond TG, Fox CM. Applying the Rasch model: fundamental measurement in the human sciences. 3nd edn. Mahwah, NJ: Lawrence Erlbaum Associates Publishers; 2015.

Linacre JM. Optimizing rating scale category effectiveness. J Appl Meas 2002; 3: 85-106.

Boone WJ, Staver JA, Yale MS. Rasch Analysis in the human sciences. Dordrecht: Springer; 2020

Fisher WJ. Rating Scale Instrument Quality Criteria. Rasch Measurement Transactions 2018; 21.

Smith R, Schumacker R, Bush J. Using item mean squares to evaluate fit to the Rasch model. J Outcome Meas 1998; 2: 66-67.

Linacre JM. Largest residual correlations for items. 2019 [cited 2019 Jan 28]; Available from: https://www.winsteps.com/winman/table23_99.htm.

Christensen K, Makransky G, Horton M. Critical values for Yen's Q3: identification of local dependence in the Rasch model using residual correlation. Appl Psychol Meas 2017; 41: 178-194.

https://doi.org/10.1177/0146621616677520 DOI: https://doi.org/10.1177/0146621616677520

Linacre JM. Dimensionality: contrasts & variances. 2019 [cited 2019 Jan 28]; Available from: https://www.winsteps.com/winman/principalcomponents.htm

World Health Organizatin (WHO). International Classification of Functioning, Disability and Health. Geneva: WHO; 2001.

Published

2023-09-26

How to Cite

Holmefur, M., Elvrum, A.-K. G., & Krumlinde-Sundholm, L. (2023). The assisting hand assessment for children and youth with brachial plexus birth injury: a study of validity and item hierarchy of AHA-Plex. Journal of Rehabilitation Medicine, 55, jrm15325. https://doi.org/10.2340/jrm.v55.15325

Issue

Section

Original Report

Categories