Turkish Version of Hand-Use-at-Home Questionnaire
Condition: Cerebral Palsy; Brachial Plexus Palsy
MeSH terms: Paralysis; Cerebral Palsy
Study type: Observational

Summary: 
      To investigate the validity and reliability of the Turkish Version of parent-rated
      Hand-Use-at- Home questionnaire (HUH) in children with neonatal brachial plexus palsy or
      unilateral cerebral palsy.
    

Detailed description: 
      Cerebral Palsy (CP) is defined as a permanent but non-progressive disorder group that affects
      the developing fetal or infantile brain, leading to impairment in movement and posture,
      thereby limiting physical activity and participation. The prevalence of CP in society is
      around 0.21%. In a study conducted in Turkey, this ratio of 4.4 / 1000 live births has been
      reported. Motor disorders in CP often are accompanied by sensory, perceptual, cognitive,
      communicative and behavioral problems and secondary musculoskeletal problems.

      Obstetric brachial plexus (OBP) injury is a common peripheral nerve injury in children. Its
      incidence is reported between 0.42 and 5.1 per 1000 live births. As the primary mechanism of
      injury, it is accepted that traction or compression of all or part of the brachial plexus.

      In these patients, weakness in the upper extremity, long-term contractures, and difficulties
      in the use of the extremities occurs due to the damage of nerves. In both diseases, patients
      have difficulty in bimanual activities.

      Many treatment methods focus on increasing the use of upper extremities of patients and
      ensuring their independence in daily life activities. There are many methods for evaluating
      the hand use performance of patients and the effectiveness of different treatment methods.
      However, these clinical evaluation methods often do not reflect the patient's performance at
      home, at school, in their daily living environments.

      The "Hand Use at Home (HUH)" questionnaire, which was created to be evaluated by parents, was
      developed in 2017 for measuring and evaluating the spontaneous use time of unilateral paretic
      children aged 3-10 in the affected hand and arm daily life activities.

      The validity and reliability of the questionnaire were determined in children with obstetric
      brachial plexus paralysis and unilateral SP.

      The purpose of this study; The translation of the HUH questionnaire into Turkish is to
      investigate its cultural adaptation, validity, and test-retest reliability.
    

Intervention name(s): Hand-Use-at-Home Questionnaire (HUH); Pediatric Outcome Data Collection Instrument (PODCI); Children's Hand-Use Experience Questionnaire (CHEQ)
Intervention type(s): Behavioral; Behavioral; Behavioral
Intervention description(s): The HUH assesses the amount of spontaneous use of the affected hand in children with unilateral upper limb paresis aged 3-10 years, performing 18 typical bimanual play and self-care activities. Parents rate items using a 5-point rating scale (never-sometimes-regularly-often-always). After completion, the ratings are converted into a 3-point score (i.e. never/sometimes = score 0, regularly/ often = score 1, always = score 2). A sum score can be calculated (range 0-36).; The PODCI is designed to assess different aspects of daily living in children with musculoskeletal disorders. It has excellent psychometric properties, and it is a widely accepted instrument to provide parent/patient-reported information about upper extremity functioning. A Dutch version is available and it is validated for children with neonatal brachial plexus palsy. It consists of 85 questions and five scale scores and one total score can be calculated (range for all scales and total score 0-100, higher scores indicating better functioning/quality of life). Only the Upper Extremity and Physical Function Scale (8 items) were used in this study since this scale provides information about difficulties performing activities using the arms/hands (score 0-100; lower score, more difficulties).; The CHEQ is a questionnaire for children (aged 6-18) with unilateral functional limitations of hand use and is well validated for children with unilateral cerebral palsy. It was only partially validated for use in children with neonatal brachial plexus palsy and has not yet been used in studies. Therefore, it was not used in this group. The questionnaire consists of 29 bimanual activities, typically requiring the use of both hands. It assesses the child's experience using their affected hand when performing the activities and counts how many of the activities are executed independently (with and without using the affected hand).
In the mini-version of the CHEQ some items were deleted or replaced (with more age-appropriate activities for children aged three to eight years) and this version was used for all unilateral cerebral palsy children <six years in this study.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        42 unilateral cerebral palsy patients and 25 brachial plexus palsy between 3 - 10 years of
        age.
      
Keywords: brachial plexus; unilateral cerebral palsy; hand function; child rehabilitation; upper extremity; hand use at home questionnaire