RESUMEN
OBJECTIVE: To validate the upper limb assessments tool, Shriners Hospital Upper Extremity Evaluation (SHUEE), for individuals with hemiplegic cerebral palsy in the Brazilian population. METHODS: Validation study to translate and culturally adapt the Manual and the instrument. The psychometric properties evaluated were reliability and convergent validity. Reliability was determined by internal consistency (Cronbach's α coefficient), ceiling and floor effect, sensitivity to changes, and intra- and interobserver agreement. Convergent validity was performed using the Pediatric Motor Activity Log, the self-care scale of the Pediatric Evaluation of Disability Inventory, and the Manual Ability Classification System. RESULTS: We evaluated 21 individuals with hemiplegic cerebral palsy, with a mean age of 8.7±4.0 years. After the instrument was translated, there was no need for cultural adaptation. The total Cronbach's α coefficient was 0.887 (95% confidence interval [95%CI] 0.745-0.970). We calculated sensitivity to changes in five subjects who underwent treatment with Botulinum Toxin Type A and physical therapy, with a significant difference between pre- and post-treatment evaluations in the Spontaneous Functional Analysis and Dynamic Positional Analysis. Convergent validity showed a significant correlation of the Spontaneous Functional Analysis and Dynamic Positional Analysis with the scales evaluated. All items of SHUEE presented high intra- and interobserver agreement. CONCLUSIONS: The results revealed that the Brazilian version of the SHUEE demonstrated good reliability and convergent validity, suggesting that it is an adequate and reliable tool for individuals with hemiplegic cerebral palsy in the Brazilian population.
Asunto(s)
Parálisis Cerebral/fisiopatología , Evaluación de la Discapacidad , Examen Neurológico/normas , Extremidad Superior/fisiopatología , Brasil , Niño , Preescolar , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados , TraduccionesRESUMEN
ABSTRACT Objective: To validate the upper limb assessments tool, Shriners Hospital Upper Extremity Evaluation (SHUEE), for individuals with hemiplegic cerebral palsy in the Brazilian population. Methods: Validation study to translate and culturally adapt the Manual and the instrument. The psychometric properties evaluated were reliability and convergent validity. Reliability was determined by internal consistency (Cronbach's α coefficient), ceiling and floor effect, sensitivity to changes, and intra- and interobserver agreement. Convergent validity was performed using the Pediatric Motor Activity Log, the self-care scale of the Pediatric Evaluation of Disability Inventory, and the Manual Ability Classification System. Results: We evaluated 21 individuals with hemiplegic cerebral palsy, with a mean age of 8.7±4.0 years. After the instrument was translated, there was no need for cultural adaptation. The total Cronbach's α coefficient was 0.887 (95% confidence interval [95%CI] 0.745-0.970). We calculated sensitivity to changes in five subjects who underwent treatment with Botulinum Toxin Type A and physical therapy, with a significant difference between pre- and post-treatment evaluations in the Spontaneous Functional Analysis and Dynamic Positional Analysis. Convergent validity showed a significant correlation of the Spontaneous Functional Analysis and Dynamic Positional Analysis with the scales evaluated. All items of SHUEE presented high intra- and interobserver agreement. Conclusions: The results revealed that the Brazilian version of the SHUEE demonstrated good reliability and convergent validity, suggesting that it is an adequate and reliable tool for individuals with hemiplegic cerebral palsy in the Brazilian population.
RESUMO Objetivo: Validar o instrumento de avaliação do membro superior, Shriners Hospital Upper Extremity Evaluation (SHUEE), para indivíduos com paralisia cerebral hemiplégica da população brasileira. Métodos: Estudo de validação no qual foi realizada tradução e adaptação cultural do manual e do instrumento. As propriedades psicométricas avaliadas foram confiabilidade e validade convergente. A confiabilidade foi determinada através da consistência interna (coeficiente α de Cronbach), efeito teto e chão, sensibilidade à mudança e concordância intra e interobservador. A validade convergente foi realizada utilizando-se o Pediatric Motor Activity Log, a escala de autocuidados do Pediatric Evaluation of Disability Inventory e o Manual Ability Classification System. Resultados: Foram avaliados 21 indivíduos com paralisia cerebral hemiplégica com idade média de 8,7±4,0 anos. Após a tradução do instrumento, não houve necessidade de adaptação cultural. O coeficiente α de Cronbach total foi de 0,887 (intervalo de confiança de 95% [IC95%] 0,745-0,970). A sensibilidade à mudança foi calculada em cinco indivíduos que realizaram aplicação de Toxina Botulínica tipo A e fisioterapia, apresentando diferença significativa entre a avaliação pré e pós-tratamento na Análise Funcional Espontânea e Análise Posicional Dinâmica. A validade convergente mostrou correlação significativa da Análise Funcional Espontânea e Análise Posicional Dinâmica com as escalas avaliadas. Todos os itens do SHUEE apresentaram concordâncias fortes, tanto na avaliação intra quanto na interobservador. Conclusões: A versão brasileira do SHUEE demonstrou um bom desempenho em relação à confiabilidade e validade convergente, sugerindo ser uma ferramenta adequada e confiável para os indivíduos com paralisia cerebral hemiplégica na população brasileira.