Publications by authors named "Lena Krumlinde-sundholm"
Purpose: To evaluate the association between upper-limb (UL) clinical tests and UL accelerometry-derived metrics in children with unilateral Cerebral Palsy (CP).
Methods: In this cross-sectional study, twenty children with unilateral CP and Manual Ability Classification System level I-III were included. Outcomes of the Assisting Hand Assessment, Box and Block-Test and accelerometry metrics were collected in the clinical setting and in daily life.
Aim: To develop a screening tool (the screening Hand Assessment for Infants [s-HAI]) for infants aged from 3.5 months that can identify a high risk of developing unilateral cerebral palsy (CP) based on a selection of items from the HAI.
Method: Receiver operating characteristic curve analysis was performed on previously collected HAI assessments from 212 infants (104 females, 108 males) aged from 3.
Article Synopsis
- The study aimed to evaluate the Assisting Hand Assessment (AHA) for children with brachial plexus birth injury and determine its internal scale validity for this specific group.
- The researchers analyzed data from 105 participants aged between 18 months to 18 years, finding that the scale's 20 items were reliable and could be effectively reduced to 15 items without compromising quality.
- The revised assessment, dubbed AHA-Plex, exhibited strong internal validity and provided a unique item difficulty hierarchy tailored for individuals with this condition.
Article Synopsis
- The aim of the study was to develop a shorter, user-friendly version of the Dyskinesia Impairment Scale (DIS-II) for assessing dystonia and choreoathetosis, while evaluating its validity and reliability.
- The DIS-II evaluates these conditions in 11 body regions with fewer videos needed (14 instead of 26) and a reduced number of scoring items (88 instead of 144), while maintaining good construct validity and distinguishing between eight ability levels.
- Overall, the DIS-II improves upon the original scale by providing valid and reliable measures with simpler scoring and better comparison capabilities for clinical practice and research.
Article Synopsis
- The study examines the use of upper-limb botulinum neurotoxin A (BoNT-A) in children with cerebral palsy (CP) across five regions in Sweden, focusing on factors influencing initial treatment decisions.
- Out of 496 children analyzed, 22% received BoNT-A, with a significant number treated before age 4; those with higher severity levels showed a greater likelihood of treatment.
- Findings suggest that having full passive range of motion combined with tightness at the end of movement increases the chances of receiving BoNT-A, highlighting the importance of considering this in treatment discussions.
Aim: To investigate the external validity of the Both Hands Assessment (BoHA), a new test evaluating bimanual performance in children with bilateral cerebral palsy (CP), by analysing its relationship to established measurements of hand function and self-care skills.
Method: In this cross-sectional study, we recruited children with bilateral CP and manual ability corresponding to Manual Ability Classification System (MACS) levels I to III attending three habilitation units in Norway. All participants completed the BoHA.
Objective: To determine similarities and differences in key predictors of recovery of bimanual hand use and unimanual motor impairment after stroke.
Method: In this prospective longitudinal study, 89 patients with first-ever stroke with arm paresis were assessed at 3 weeks and 3 and 6 months after stroke onset. Bimanual activity performance was assessed with the Adult Assisting Hand Assessment Stroke (Ad-AHA), and unimanual motor impairment was assessed with the Fugl-Meyer Assessment (FMA).
Interrater and test-retest reliability of the Hand Assessment for Infants.
Dev Med Child Neurol
December 2021
Article Synopsis
- The study explores the reliability of the Hand Assessment for Infants (HAI), focusing on interrater and test-retest reliability, as well as the standard error of measurement (SEM) and smallest detectable difference (SDD).
- The assessment was conducted on 55 infants, including those with unilateral cerebral palsy and typically developing infants, using ratings from three experienced occupational therapists.
- The results indicate that HAI has excellent reliability scores (ICCs of 0.96-0.99), with low SDDs (2 points for Each Hand Sum and 3 units for Both Hands Measure), confirming that any changes reported beyond these values are meaningful in both research and clinical settings.
Importance: Cerebral palsy (CP) is the most common childhood physical disability. Early intervention for children younger than 2 years with or at risk of CP is critical. Now that an evidence-based guideline for early accurate diagnosis of CP exists, there is a need to summarize effective, CP-specific early intervention and conduct new trials that harness plasticity to improve function and increase participation.
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- The study evaluates the Hand Assessment for Infants (HAI) to identify infants likely to develop unilateral cerebral palsy (CP), analyzing its effectiveness across different ages.
- Sensitivity and specificity of HAI showed a range of 63%-93% and 62%-91%, respectively, indicating it can be a reliable tool for early detection in infants assessed between 3.5 to 12 months.
- The findings suggest that using HAI cut-off values can enhance clinical practices for the timely identification and intervention of infants at risk for unilateral CP.
Article Synopsis
- The Dyskinesia Impairment Scale (DIS) was developed to assess dystonia and choreoathetosis specifically in children and youth with dyskinetic cerebral palsy, unlike the existing Burke-Fahn-Marsden Dystonia Rating Scale (BFM) that's mainly used for inherited dystonia.
- The study evaluated the reliability and validity of the DIS through various statistical methods, showing high inter-rater and test-retest reliability with notable correlation to the BFM scale.
- Results indicated that the DIS is a reliable and valid tool for assessing dystonia and choreoathetosis in its target population, making it a promising option for clinical use.
The aim is to evaluate the feasibility of an intervention model with a client-centered goal-directed approach with the aim to enhance the child's participation in leisure activities, self-efficacy, and activity performance. A pilot intervention using a client-centered goal-directed approach and a single-subject design was performed. Two Swedish boys with neuropsychiatric diagnosis aged 12 and 14 years old were included, and 3 leisure activity goals were identified.
View Article and Find Full Text PDFArticle Synopsis
- - The study aimed to establish normative reference values for hand use in infants at risk of cerebral palsy (CP) by utilizing the Hand Assessment for Infants (HAI), focusing on infants aged 3 to 12 months.
- - Researchers conducted 489 HAI assessments on typically developing infants from Italy and Sweden, finding consistent growth patterns in hand use with no significant differences based on sex or nationality, and only a negligible difference between right and left hand use.
- - The findings provide valuable HAI reference values to help detect atypical hand use in infants, with a result below 2 standard deviations from the mean indicating a potential concern, while most typically developing infants showed no hand use asymmetry.
Article Synopsis
- The study aimed to analyze the development of passive range of motion (ROM) in the upper limbs of children with cerebral palsy (CP) and identify factors that contribute to the likelihood of developing contractures.
- Data from 771 children with CP showed that 34% developed contractures, with significant decreases in passive ROM observed starting at an average age of 4 for wrist extension and 7 for shoulder flexion and elbow movement.
- The strongest predictor for developing contractures was the child's level on the Manual Ability Classification System (MACS), with those at MACS level V being 17 times more likely to develop contractures than those at level I.
Objective: To investigate interrater and intrarater reliability, measurement error, and convergent and discriminative validity of the Adult Assisting Hand Assessment Stroke (Ad-AHA Stroke).
Design: Cross-sectional observational study.
Setting: A total of 7 stroke rehabilitation centers.
Aim: To describe the development of bimanual performance among young children with unilateral or bilateral cerebral palsy (CP).
Method: A population-based sample of 102 children (53 males, 49 females), median age 28.5 months (interquartile range [IQR] 16mo) at first assessment and 47 months (IQR 18mo) at last assessment, was assessed half-yearly with the Assisting Hand Assessment (AHA) or the Both Hands Assessment (BoHA) for a total of 329 assessments.
Aim: To explore the effectiveness of baby-CIMT (constraint-induced movement therapy) and baby-massage for improving the manual ability of infants younger than 12 months with unilateral cerebral palsy (CP).
Method: Infants eligible for inclusion were 3-8 months old with asymmetric hand function and at high risk of developing unilateral CP. Thirty-seven infants were assigned randomly to receive baby-CIMT or baby-massage.
Aims: To describe the development of a new test of bimanual performance for adults following Stroke, the Adult-Assisting Hand Assessment Stroke, and to report the evidence of internal and external validity.
Methods: Scale development included: (i) establishing the test situation; (ii) constructing test items; (iii) evaluating internal construct validity by use of Rasch measurement analysis on 144 assessments of adults with hemiparesis, mean age 53 years (SD11.45); and (iv) investigating external validity by correlation to the Jebsen and Taylor Test of Hand Function and the ABILHAND Stroke.
Development of the Hand Assessment for Infants: evidence of internal scale validity.
Dev Med Child Neurol
December 2017
Article Synopsis
- The study aims to create and evaluate an assessment tool for upper limb function in infants aged 3 to 12 months, focusing on those at risk for unilateral cerebral palsy.
- The Hand Assessment for Infants (HAI) includes 12 unimanual and 5 bimanual tasks, scored using a 3-point scale, and shows strong reliability and unidimensionality according to the Rasch model.
- The HAI effectively measures and quantifies bilateral hand use and asymmetry, proving to be a valid tool for assessing infants' hand function and tracking developmental concerns related to unilateral cerebral palsy.
Importance: Cerebral palsy describes the most common physical disability in childhood and occurs in 1 in 500 live births. Historically, the diagnosis has been made between age 12 and 24 months but now can be made before 6 months' corrected age.
Objectives: To systematically review best available evidence for early, accurate diagnosis of cerebral palsy and to summarize best available evidence about cerebral palsy-specific early intervention that should follow early diagnosis to optimize neuroplasticity and function.
Aim/objective: To explore and describe parents' perceptions and experiences of conducting a goal-directed intervention focused on children's self-identified goals.
Material And Methods: Individual semi-structured interviews were performed with nine parents (8 mothers, 1 father). All the parents had participated actively in conducting a goal-directed intervention addressing their children's self-identified goals.
Aim: To investigate the interrater and test-retest reliability of the Assisting Hand Assessment in adolescents (Ad-AHA) with cerebral palsy (CP) and to evaluate the alternate-form reliability of different test activities.
Method: Participants were 112 adolescents with unilateral CP (60 males, 52 females; mean age 14y 5mo [standard deviation {SD} 2y 8mo], Manual Ability Classification System levels I-III). Reliability was evaluated using intraclass correlation coefficients (ICC), smallest detectable change (SDC), and Bland-Altman plots.
Aims: To develop a hand function test for children with bilateral cerebral palsy (CP) measuring bimanual performance, including quantification of possible asymmetry of hand use.
Method: The Both Hands Assessment (BoHA) content was developed through adaptation of the Assisting Hand Assessment (version 5.0).
Aim: To describe aspects of hand function in a population-based sample of young children with clinical signs of unilateral or bilateral cerebral palsy (CP).
Method: A cross-sectional study with data from national CP registers in Norway. Manual ability was classified with the Manual Ability Classification System (MACS) or Mini-MACS.
Aim: To develop and evaluate a test activity from which bimanual performance in adolescents with unilateral cerebral palsy (CP) can be observed and scored with the Assisting Hand Assessment (AHA), and to evaluate the construct validity of the AHA test items for the extended age range 18 months to 18 years.
Method: A new test activity was developed and evaluated for its ability to elicit bimanual actions in adolescents with (n=20) and without (n=10) unilateral CP. The AHA scores of 126 adolescents (mean age 14y 3mo, SD 2y 6mo; 71 males, 55 females) and 157 children with unilateral CP (mean age 6y 1mo, SD 2y 10mo; 102 males, 55 females) were analysed using the Rasch measurement model.