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

AimABILHAND-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. MethodIn 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. ResultsThe 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. InterpretationThe 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.