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The Neurological Hand Deformity Classification for children with cerebral palsy
Author(s) -
Georgiades Melissa,
Elliott Catherine,
Wilton Judith,
Blair Eve,
Blackmore Marie,
Garbellini Simon
Publication year - 2014
Publication title -
australian occupational therapy journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.595
H-Index - 44
eISSN - 1440-1630
pISSN - 0045-0766
DOI - 10.1111/1440-1630.12150
Subject(s) - cerebral palsy , deformity , medicine , wrist , upper limb , physical medicine and rehabilitation , physical therapy , surgery
Background/aim The purpose of this study was to evaluate the reliability of the Neurological Hand Deformity Classification and use it to describe changes in hand deformity over time in children with cerebral palsy. Methods We identified 114 video clips of 26 children with cerebral palsy, aged 1–18 years (mean = 8.4, SD = 4.2), performing upper‐limb tasks at multiple time points ( n = 3–8) at least 6 months apart. Using the Neurological Hand Deformity Classification, three observers classified hand deformity in the video clips. Inter‐ and intra‐observer reliabilities were estimated using Fleiss and Cohen's kappa (κ) and the temporal changes in classification of hand deformity were investigated. Results Inter‐ and intra‐observer reliability respectively were κ = 0.87 and κ = 0.91. Hand deformity was identified in all children at all time points, even before the age of 2 years. Ten children did not change hand classification, wrist flexion increased in eight, and eight showed changes from wrist flexion to extension or vice versa. Conclusions The Neurological Hand Deformity Classification is a reliable tool to classify hand deformity in children with cerebral palsy. For more than one‐third of children hand deformity classification did not change. For the remaining children, two patterns of change in hand deformity over time were identified. It is recommended that children with cerebral palsy involving their upper limbs be monitored regularly. Significance of the study This is the first study to document longitudinal changes in hand deformity in children with cerebral palsy.