Article

The aim of this study was to test and improve the unidimensionality and item
hierarchy of the Modified House Classification (MHC) for the assessment of upper
limb capacity in children with unilateral cerebral palsy (CP) using Rasch
analysis. The construct validity of the Rasch-reduced item set was evaluated.
METHOD: Modified House Classification items were scored from 369 videotaped
assessments of 159 children with unilateral CP (98 males, 61 females; median age
6y 6mo, range 2y 1mo-17y 5mo). Construct validity was tested in 40 other children
with unilateral CP (21 males, 19 females; median age 8y 2mo, range 3y 3mo-17y
6mo) by comparing total scores with the Manual Ability Classification System
(MACS) and the ABILHAND-Kids scale. RESULTS: Fifteen MHC items could be included
in the Rasch analysis. The excluded items were either too easy or too difficult.
Fourteen items fitted the unidimensional model (chi(2) =41.3, df=39, p=0.37). The
hierarchy of these items was different from the original MHC. There was a
significant correlation with the MACS (r=-0.901, p<0.001) and the ABILHAND-Kids
scale (r=0.558, p<0.001). INTERPRETATION: The original item hierarchy of the MHC
can be improved in order to use its sum score for the assessment of upper limb
capacity in children with unilateral CP. The Rasch-reduced 14-item MHC with
weighted sum score shows good construct validity to measure functional capacity
of the affected hand in children with unilateral CP.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS