Abstract
Primary Author and Speaker: Patty Coker-Bolt
Additional Authors and Speakers: Thomas Platt, Emily Graves, Ashley Brady, Haley Ranson, Kat Jones, Craig Velozo
The Vietnamese Ministry of Health has determined a need for new rehabilitation models for children with cerebral palsy (CP) (Humanity & Inclusion, 2018). Approximately 500,000 children in Vietnam have CP, accounting for 30-40% of children with disabilities. Vietnamese therapists do not use pre/post-assessments to guide clinical decision making (Khandaker et al., 2017). Two commonly used assessments for CP are the PMAL (Pediatric Motor Activity Log) and ABILHAND-Kids (Bleyenheuft et al., 2016; Matuti et al., 2016). These assessments can help therapists individualize goals, target interventions, and engage families in therapy. The aim of this study was to adapt and validate Vietnamese versions of the ABILHAND-Kids and PMAL for the treatment of children with CP. We hypothesized all items of the adapted assessments would fit the Rasch model.
This was a prospective cohort study. Participants were therapists from the Hanoi Rehabilitation Hospital and the Ho Chi Minh City Children’s Hospital 1 who work with children 3-15 years old who have been diagnosed with hemiparetic CP. Data was collected on the ABILHAND-Kids and PMAL. The ABILHAND-Kids is a 21-item parent-report questionnaire measuring manual abilities in children with CP (Bleyenheuft et al., 2017). The PMAL is a 16-item structured interview intended to examine how often and how well a child uses his/her involved upper extremity in their natural environment (Matuti et al., 2016). Our cultural adaptation of the ABILHAND-Kids and PMAL followed guidelines set forth by previous studies (Matuti et al., 2016). This included translation and back translation with the assistance of a Vietnamese physical therapist. After finalizing a Vietnamese version of each assessment, we pilot tested both by collecting data from Vietnamese therapists at hospitals mentioned above. Therapists were trained on how to administer each assessment. Data was analyzed using Rasch analysis.
During the cultural adaptation of the ABILHAND-Kids, the therapists recommended that 1 item be deleted (opening a bread box) and 5 items added (using chopsticks, folding a shirt, zipping up pants, washing hands, and putting on a jacket) to include items relevant in the Vietnamese culture. Data collected from the Vietnamese ABILHAND-Kids (n=44) revealed the new measure has good person separation reliability of 0.90, Cronbach alpha (KR-20) of 0.95 and separated the sample into 4.27 strata. All items fit the Rasch measurement model. Cultural adaptation of the PMAL revealed no major language specific/cultural differences and no items were deleted or added. Data collected from the Vietnamese PMAL (n=33) revealed all items of “how often” scale fit the Rasch model; 14/16 items of “how well” scale fit the model. The 2 items that did not fit the model were turning a knob and pushing arm through a sleeve; since this is a pilot study, we do not recommend removing misfit items at this time. Cronbach’s alpha of the 2 scales was between 0.93-0.96 & separated sample into 4.59-5.85 strata.
Vietnamese versions of the ABILHAND-Kids and PMAL are valid measures of a child’s abilities to complete real-world activities. Parent/clinician report measures are influenced by cultural views of meaningful occupations. Cultural differences in children’s daily occupations and life habits may influence the perceived difficulty of real-world activities (Matuti et al., 2016).
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Humanity & Inclusion (2018). Guideline for the Care of Children with Cerebral Palsy in Vietnam.
Khandaker, G., Van Bang, N., Dũng, T. Q., Giang, N. T. H., Chau, C. M., Van Anh, N. T., Van Thuong, N., Badawi, N., & Elliott, E. J. (2017). Protocol for hospital based-surveillance of cerebral palsy (CP) in Hanoi using the Paediatric Active Enhanced Disease Surveillance mechanism (PAEDS-Vietnam): a study towards developing hospital-based disease surveillance in Vietnam. BMJ open, 7(11), e017742. doi:10.1136/bmjopen-2017-017742
Matuti, et al. (2016). Translation and cross cultural adaptation of the Pediatric Motor Activity Log-Revised scale. Arquivos de neuro-psiquiatria, 74(7), 555-560. doi:10.1590/0004-282X20160084}