Development of a set of activities to evaluate the arm and hand function in children with obstetric brachial plexus lesion.

OBJECTIVE

To develop an observational instrument that can be used to evaluate the quality of arm and hand skills in daily functional activities in children with obstetric brachial plexus lesion (OBPL). A set of functional activities was constructed and standardized, and the intra-observer reliability of the assessment of this set of activities was studied.

SETTING

Department of Occupational Therapy and Department of Rehabilitation Medicine, VU University Medical Centre.

SUBJECTS: Twenty-six children with OBPL in the age range of 4 -6 years.

INTERVENTIONS: The children were asked to perform 47 bimanual activities, which were recorded on videotape.

MAIN MEASURES: The videotapes were scored twice by the same occupational therapist.

RESULTS

The percentage of agreement in scoring 'hand-use', 'speed' and 'assistance' was over 80% for a substantial number of activities, indicating a strong agreement. However, in scoring 'deviations in movements and body posture' the percentage of agreement was insufficient in most activities.

CONCLUSIONS

This set of activities has good potential for assessment of the performance of functional activities in children with OBPL. This study, however, showed a number of difficulties in observing and scoring the activities that have to be considered when developing a standardized video observation.