Description des outils d’évaluation de la performance bimanuelle validés en neurologie pédiatrique

Summary :

The assessment of hand function in pediatric neurology underwent a revolution in the early 2000 in parallel with the development and structuration of activity-centered and goal-directed therapeutic approaches for children with cerebral palsy. New tools have been developed, focusing on bimanual performance, i.e. the real and natural use of both hands to perform bimanual tasks, rather than the unilateral motor capacities of either upper limb. Bimanual performance can be assessed using questionnaires that explore the person’s perception, or using tools based on direct observation. The tools presented here have been developed for children who are at risk of cerebral palsy, or who present cerebral palsy or obstetric brachial plexus palsy.
These tools all use video recording of a semi-standardised play session (or functional task), which is then rated according to rating criteria. The Rasch model, used to develop these assessment tools, has enabled the study of their clinimetric properties and the obtention of interval scales that can be used in research. In addition, the Rasch analysis provided a hierarchy of items according to difficulty, which is very useful for guiding treatments.
The tools presented in this article are :
– the HAI (Hand Assessment for Infants), a diagnostic tool which assesses the manual function of babies between 3 and 12 months, using 12 unimanual items and 5 bimanual items ;
– the Mini-AHA (Mini-Assisting Hand Assessment) and the AHA, which assess how effectively children with unilateral impairment use their assisting hand in bimanual performance. These tools are aimed respectively at babies aged between 8 and 18 months and children aged between 18 months and 18 years, with different test procedures depending on children’s ages. The AHA-Plex is a special version of the AHA for children with brachial plexus paralysis ;
– the BoHA (Both Hands Assessment), which assesses the manual function of children aged between 18 months and 12 years with bilateral cerebral palsy, using 12 unimanual items and 5 bimanual items.

Article rédigé par :

• 

  Rachel Bard-Pondarré

  Ergothérapeute, MSc OT
  Formatrice
  Centre des Massues, Croix-Rouge française
  Lyon, France
  Rachel.BardPondarre@croix-rouge.fr

  
  
• 

  Noriko Funakoshi

  Ergothérapeute, MSc OT
  Formatrice
  Hôpital Armand-Trousseau, AP-HP
  Unité MPR pédiatrique
  Paris, France

  
  
• 

  Ellen Romein

  Ergothérapeute, MSc OT
  Formatrice