Abstract
Aim
To describe bimanual performance in a sample of Australian children with bilateral cerebral palsy (CP) and, examine the qualitative meaning (or interpretability) of scores on the Both Hands Assessment (BoHA).
Methods
Children with bilateral CP aged 8–12 years (n = 54) classified Manual Ability Classification System (MACS) level I = 20, II = 18, III = 16 were examined using the BoHA.
Results
Bimanual performance was significantly different across MACS levels I-III (p < 0.001). Mean (95%CI) BoHA-unit for each MACS level were I = 85 (81–89), II = 72 (68–76) and III = 53 (49–56). Children with asymmetrical hand use (≥ 20% difference between upper limbs, n = 10) were classified MACS levels II and III and had a mean (95%CI) BoHA-unit of 56 (51–62). Children with symmetrical hand use were classified in MACS level I-III and had a mean (95%CI) BoHA-unit of 74 (70–79).
Conclusions
The BoHA quantified observations of bimanual performance for children with bilateral CP, differentiated between MACS levels I-III and provided clinically meaningful information. The BoHA may facilitate tailoring of upper limb intervention. Future research is recommended to examine inter-rater and intra-rater reliability and responsiveness of the BoHA, as well as longitudinal studies of bimanual hand skill development in children with bilateral CP.
Acknowledgements
The authors give thanks to Dr Ann Kristin Elvrum for giving of her time and expertise to provide feedback to Andrea Burgess on her rating of five videos used in this study.
Disclosure statement
The authors report that no financial interest or benefit has arisen from the applications of this research.
Correction Statement
This article has been republished with minor change. This change do not impact the academic content of the article.
Additional information
Funding
Notes on contributors
Andrea Burgess
Andrea Burgess is an Occupational Therapist and PhD student in the Faculty of Medicine at The University of Queensland. Her research has focused on the development of self-care skills and hand function in children with cerebral palsy.
Roslyn Nancy Boyd
Roslyn Nancy Boyd is Professor of Cerebral Palsy Research at the Queensland Cerebral Palsy and Rehabilitation Research Centre the Faculty of Medicine at the University of Queensland. Prof Boyd's research focuses on the early detection and early intervention for infants with Cerebral Palsy in high and low resource settings.
Mark David Chatfield
Mark David Chatfield is a Senior Biostatistician in the Faculty of Medicine at The University of Queensland. He has worked with the co-authors researching cerebral palsy since 2018.
Jenny Ziviani
Jenny Ziviani is Professor of Occupational Therapy in the School of Health and Rehabilitation Sciences at The University of Queensland. Her research focuses on family centred interventions for children with developmental disabilities, their motivational components, and how to enhance therapeutic engagement.
Leanne Sakzewski
Leanne Sakzewski is an Associate Professor at the Queensland Cerebral Palsy and Rehabilitation Research Centre at The University of Queensland. Her research focuses on novel interventions to improve motor, social and participation outcomes of infants, children and adolescents with cerebral palsy and acquired brain injuries.