Validity and reliability of the Turkish version of the hand-use-at-home questionnaire for children with unilateral cerebral palsy and neonatal brachial plexus palsy

Abstract

Purpose

To translate the Hand-Use-at-Home questionnaire (HUH), assesses the amount of spontaneous use of the affected hand in children with 18 bimanual activities, into Turkish and examine its validity and reliability on children with neonatal brachial plexus palsy (NBPP) or unilateral cerebral palsy (UCP).

Materials and methods

The HUH was translated and cross-culturally adapted to Turkish and administered to children with NBPP (n = 25) and UCP (n = 42) between 3 and 10 years. The psychometric analyses included reliability by internal consistency (Cronbach’s alpha) and test/retest reliability (intraclass correlation coefficient, ICC) structural validity was evaluated with exploratory factor analysis, and construct validity was investigated by matching the HUH with the Pediatric Outcome Data Collection Instrument Upper Extremity Scale (PODCI) (NBPP only), and Children’s Hand-Use Experience Questionnaire (CHEQ) (UCP only).

Results

HUH showed excellent test–retest reliability (ICC2,1 = 0.988 Cl (0.977–0.992)), excellent internal consistency (Cronbach’s-α = 0.989), and moderate correlation with CHEQ (rs = 0.558) in UCP and high correlation with PODCI Scale (rs = 0.789) in NBPP group. The HUH had low and moderate correlation respectively lesion-extent levels (r=-0.457) in NBPP and 5 Manual Ability Classification System levels (r=-0.688) in the UCP group.

Conclusion

The HUH is a valid and reliable tool to assess the amount of spontaneous use of the affected hand in Turkish children with NBPP and UCP.

iMPLICATIONS FOR REHABILITATION

• The Hand-Use-at-Home (HUH) questionnaire is a reliable and good valid outcome measure to evaluate the amount of spontaneous use of the affected hand.

• We suggest the Turkish version of the HUH be used in the Turkish children to indicate small changes in the severity of disorder of children until a normal quality of life is achieved.

• The HUH can be used with high reliability and validity by experienced and inexperienced doctors and physiotherapists.

Keywords:

• Brachial plexus
• cerebral palsy
• hand function
• pediatric rehabilitation
• upper extremity

Acknowledgements

We wish to thank Yvonne Geerdink for giving us permission to use the HUH. We also thank all the parents and children who participated in this study.

Disclosure statement

The authors report no conflict of interest.

Ethics approval and consent to participate

Ethical approvals were obtained from the Marmara University Faculty of Medicine Ethics Committee in accordance with the Declaration of Helsinki (approval number: 09.2018.712). Written informed consent and assent were obtained from all legal guardians of the participating children, respectively. The content experts submitted signed informed consent forms to indicate their willingness to participate. The trial is registered with ClinicalTrials.gov (NCT04243590).

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.