Validity and reliability of the Turkish version of the hand-use-at-home questionnaire for children with unilateral cerebral palsy and neonatal brachial plexus palsy

Abstract

PurposeTo translate the Hand-Use-at-Home questionnaire (HUH), assesses the amount of spontaneous use of the affected hand in children with 18 bimanual activities, into Turkish and examine its validity and reliability on children with neonatal brachial plexus palsy (NBPP) or unilateral cerebral palsy (UCP).Materials and methodsThe HUH was translated and cross-culturally adapted to Turkish and administered to children with NBPP (n = 25) and UCP (n = 42) between 3 and 10 years. The psychometric analyses included reliability by internal consistency (Cronbach's alpha) and test/retest reliability (intraclass correlation coefficient, ICC) structural validity was evaluated with exploratory factor analysis, and construct validity was investigated by matching the HUH with the Pediatric Outcome Data Collection Instrument Upper Extremity Scale (PODCI) (NBPP only), and Children's Hand-Use Experience Questionnaire (CHEQ) (UCP only).ResultsHUH showed excellent test-retest reliability (ICC2,1 = 0.988 Cl (0.977-0.992)), excellent internal consistency (Cronbach's-alpha = 0.989), and moderate correlation with CHEQ (rs = 0.558) in UCP and high correlation with PODCI Scale (rs = 0.789) in NBPP group. The HUH had low and moderate correlation respectively lesion-extent levels (r=-0.457) in NBPP and 5 Manual Ability Classification System levels (r=-0.688) in the UCP group.ConclusionThe HUH is a valid and reliable tool to assess the amount of spontaneous use of the affected hand in Turkish children with NBPP and UCP. The Hand-Use-at-Home (HUH) questionnaire is a reliable and good valid outcome measure to evaluate the amount of spontaneous use of the affected hand.We suggest the Turkish version of the HUH be used in the Turkish children to indicate small changes in the severity of disorder of children until a normal quality of life is achieved.The HUH can be used with high reliability and validity by experienced and inexperienced doctors and physiotherapists.