A preliminary study, published June 10 in the journal BMC Musculoskeletal Disorders, examines the use of an adaptation of the Southampton Hand Assessment Procedure (SHAP) to evaluate the functionality of children’s impaired or prosthetic hands. Because the standard SHAP cannot be used with children due to the size of the objects used to perform the tasks, researchers from the University Medical Center Groningen, Netherlands, developed a SHAP for use with children (SHAP-C) based on SHAP protocol. As part of the adaptation, researchers downsized assessment objects used in the SHAP, modified some protocols, and the rater timed the tasks instead of the participant. The SHAP-C was then tested to determine its potential norm values and reliability.
Participants used this myoelectric prosthetic simulator adapted for use by unimpaired children. Photograph courtesy of BMC Musculoskeletal Disorders and BioMed Central.
The study cohort comprised 24 children between the ages of four and six who are right-handed and unimpaired children. The age group was defined according to the opening width and functional abilities of a generally used prosthetic hand, appropriateness of the SHAP-C tasks in children, and ability of the participants to receive and follow task instructions. Participants performed all SHAP-C tasks, repeated over four sessions separated by about 24 hours. Each participant used his or her hand or a myoelectric prosthetic simulator adapted for use by unimpaired children. The children were assigned to perform the tasks every session with the same hand. Chair height was adjusted to allow 90 degrees of elbow flexion when the hand rested on the table. Each SHAP-C task was first demonstrated by the assessor, and two assessors were present during testing.
The mean times to complete the tasks ranged from 0.75 to 1.21 seconds for abstract objects and from 0.64 to 19.13 seconds for activities of daily living. Interrater and intrarater reliability were assessed and found that repeatability coefficients (RCs) of a single assessor did not exceed 75 percent in 17 of 26 SHAP-C tasks, which the researchers concluded displayed relatively good intrarater reliability, whereas the RCs for the interrater reliability exceeded 75 percent in 22 of 26 tasks, which the researchers concluded displayed poor reliability.
The researchers found that the variation was “promising,” but because intrarater reliability proved better than interrater reliability, the SHAP-C requires additional modifications to provide reliable pediatric assessment. The study authors also recommended additional research to determine the appropriate size of the objects for the hands of children older than six, for larger prosthetic hands with an opening width greater than 5cm, and for spastic hands with an opening less than 5cm, as well as to determine the effect of changes in performance due to age. Further, the SHAP-C should be evaluated in different impaired hands and in prosthetics users.
To read the study,”Preliminary study of the Southampton Hand Assessment Procedure for Children and its reliability,” visit the BioMed Central website.
