Versão brasileira do Shriners Hospital Upper Extremity Evaluation (SHUEE) : tradução, adaptação cultural e avaliação das propriedades psicométricas

Abstract

Introduction: Individuals with cerebral palsy (CP) often have upper limb impairment leading to limitations in functionality. The use of specific and validated scales assists health professionals in the understanding of these limitations and treatment planning. However, Brazil does not have available validated scales to assess the upper limb function and direct the treatment plan in individuals with CP. Objective: This thesis aimed at validating the upper limb assessment tool, Shriners Hospital Upper Extremity Evaluation (SHUEE), for individuals with hemiplegic CP of the Brazilian population. Methods: Cross-sectional validation study in which the translation of the manual and instrument was performed. The evaluated psychometric properties were reliability and convergent validity. Reliability was determined by internal consistency (Cronbach α coefficient, α-C), ceiling and floor effect, sensitivity to change and intra and interobserver agreement. Convergent validity was performed using the Pediatric Motor Activity Log (PMAL), the self-care scale of the Pediatric Evaluation of Disability Inventory (PEDI) and the Manual Ability Classification System (MACS). Results: A total of 21 individuals with hemiplegic CP, mean age of 8.73±3.98 years, were evaluated. The instrument was translated and there was no need for cultural adaptation. The total α-C coefficient of the SHUEE was 0.887 (95% CI 0.745 to 0.970). Sensitivity to change was calculated in 5 subjects who underwent application of Botulinum Toxin Type A and physical therapy, with a significant difference in the Dynamic Positional Analysis between pre and post-treatment evaluations. The convergent validity showed significant correlation of Spontaneous Functional Analysis and Dynamic Positional Analysis with PMAL, PEDI and MACS. All items of SHUEE showed high intra and inter-observer agreement (ICC greater than 0.9). Conclusion: The results presented in this thesis allow us to conclude that the Brazilian Portuguese version of SHUEE demonstrated a good reliability and convergent validity, suggesting that it is a reliable tool for the upper limb evaluation of Brazilian children and adolescents with hemiplegic CP.