Measuring changes of manual ability with ABILHAND-Kids following intensive training for children with unilateral cerebral palsy

Abstract

Aim: ABILHAND-Kids is a parent-reported questionnaire measuring manual ability in children with cerebral palsy (CP). Its psychometric properties have been established, with the exception of responsiveness, which is examined here.

Method: In this cohort study, 98 children (46 males, 52 females; range 6-19y, mean 11y, standard deviation [SD] 3.3y) with unilateral CP underwent three assessments of upper extremity function: at baseline (T1); after 80 to 90 hours of intensive training (T2); and at follow-up (T3). The responsiveness was analyzed using global, group (based on age and on Manual Ability Classification System [MACS] level), and individual approaches during two time periods (T1-T2 and T2-T3). Effect size was used to quantify magnitude of changes.

Results: The global approach showed significant improvements between T1 and T2 (p<0.001) but not between T2 and T3 (p=0.222). In the group analyses, effect size and SRM demonstrated large changes in younger children (6-12y, n=52, mean change=1.06 logit, effect size >0.8) and small changes in the older children (13-19y, n=46, mean change=0.71 logit, effect size >0.4). Children in MACS level II demonstrated larger changes than children in MACS level I or III.

Interpretation: The ABILHAND-Kids exhibited responsiveness in detecting changes after intensive training. Therefore, this scale is potentially useful in assessing the functional status of children with unilateral CP in clinical trials.