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. 2009 Nov 25:10:145.
doi: 10.1186/1471-2474-10-145.

Validity and reliability of the VOAA-DDD to assess spontaneous hand use with a video observation tool in children with spastic unilateral cerebral palsy

Pauline B M Aarts  1 , Peter H Jongerius, Yvonne A Geerdink, Alexander C Geurts
Affiliations

Validity and reliability of the VOAA-DDD to assess spontaneous hand use with a video observation tool in children with spastic unilateral cerebral palsy

Pauline B M Aarts et al. BMC Musculoskelet Disord. .

Abstract

Background: In 2003 new computer software, the VOAA (Video Observations Aarts and Aarts), was designed to score and evaluate two important aspects of spontaneous upper limb use, i.e. overall duration and frequency of specific behaviours. The aim of this study was to investigate the test-retest, interrater and intrarater reliability and the construct validity of a new module, the VOAA-DDD, to determine developmental disregard in children with spastic unilateral cerebral palsy (CP).

Methods: A test-retest design with three raters for reliability and a two-group design for construct validity were used. Subjects were a total of 20 children with spastic unilateral CP equally divided in two age groups (2.5-5 and 5-8 years), and 56 healthy children of the same age groups. Overall duration and frequency of specific behaviours of the affected arm and hand were assessed during a task demanding ('stringing beads') and a task stimulating ('decorating a muffin') the use of both hands. Reliability was estimated by intraclass correlation coefficients (ICCs). Construct validity was assessed by comparing children with CP to healthy children.

Results: All ICCs exceeded 0.87. In contrast with healthy children, children with CP used their affected hand less during the 'muffin' task compared to the 'beads' task. Of the children with CP, 90% in the age group of 2.5-5 years and 50% in the age group of 5-8 years showed values exceeding the extreme values of healthy controls, respectively, indicating developmental disregard.

Conclusion: The VOAA-DDD is a reliable and valid instrument to assess spontaneous use of the affected arm and hand in order to determine developmental disregard in children with spastic unilateral CP.

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Figures

Figure 1
Figure 1
A two-years old child stringing beads.
Figure 2
Figure 2
A five-years old child decorating a muffin.
Figure 3
Figure 3
Box plots of the differences in duration scores. Beads vs. muffin for both the children with CP and the healthy children; group 1 = age group 2.5-5 years; group 2 = age group 5-8 years.
See this image and copyright information in PMC

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