Evidence map›Paper›PMID 41548110›Full record

ArticleDevelopmental medicine and child neurology2026

Both Hands Assessment for children and adolescents with bilateral cerebral palsy: Content and construct validity.

Gøril Okkenhaug Johansen, Annoek Louwers, Melanie Hessenauer, Kari Anne Indredavik Evensen, Guro Lillemoen Andersen, Ann-Kristin Gunnes Elvrum

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Article in Developmental medicine and child neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

Authors and funding

6 authors.

Gøril Okkenhaug JohansenClinic of rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.
Annoek LouwersDepartment of Rehabilitation Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
Melanie HessenauerSpecialized Center for Paediatric Neurology, Neurorehabilitation and Epileptology, Schoen Clinic, Vogtareuth, Germany.
Kari Anne Indredavik EvensenDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.ORCID 0000-0002-0129-0164
Guro Lillemoen AndersenDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Ann-Kristin Gunnes ElvrumClinic of rehabilitation, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway.ORCID 0000-0001-9712-1447

Funding

Norges Teknisk Naturvitenskapelige Universitet Grant number 17/38297Norges Teknisk Naturvitenskapelige Universitet Project number 90393900
6 · The paper itself

Abstract

aimTo investigate the content and construct validity of the Both Hands Assessment (BoHA) for children and adolescents with bilateral cerebral palsy (CP), classified in Manual Ability Classification System (MACS) levels I to III, aged 18 months to 18 years.

methodIn this cross-sectional study, we included 61 adolescents with bilateral CP (37 males, 24 females, mean age 15 years 6 months, SD = 2 years 3 months) who were assessed with the BoHA to investigate content validity. Their BoHA results were combined with data from 210 children (121 males, 89 females, mean age 6 years 4 months, SD = 3 years 1 month), resulting in 271 BoHA assessments for the Rasch measurement model analyses investigating construct validity.

resultsAfter revising the bimanual item 'orients objects', the BoHA items were suitable for scoring bimanual performance in adolescents. Strong internal scale validity and reliable item and person measures were demonstrated for the 16 BoHA items, analysed separately for individuals with asymmetric (n = 94) and symmetric (n = 177) hand use. The BoHA logit measures were linked to the same reference frame, enabling comparable overall bimanual performance measures while maintaining separate item difficulty hierarchies.

interpretationThe BoHA scale can measure bimanual performance in individuals with bilateral CP, classified in MACS levels I to III, aged 18 months to 18 years. This allows for monitoring development and evaluating the effectiveness of intervention from early childhood to adulthood.

Indexed as

Cerebral PalsyDisability EvaluationHandMotor SkillsAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleFunctional LateralityHumansInfantMaleReproducibility of Results

Identifiers

PMID41548110
PMCPMC13340620

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