Objective: To develop an observational instrument that can be used to evaluate the quality of arm and hand skills in daily functional activities in children with obstetric brachial plexus lesion (OBPL). A set of functional activities was constructed and standardized, and the intra-observer reliability of the assessment of this set of activities was studied.
Setting: Department of Occupational Therapy and Department of Rehabilitation Medicine, VU University Medical Centre.
Subjects: Twenty-six children with OBPL in the age range of 4 -6 years.
Interventions: The children were asked to perform 47 bimanual activities, which were recorded on videotape.
Main measures: The videotapes were scored twice by the same occupational therapist.
Results: The percentage of agreement in scoring 'hand-use', 'speed' and 'assistance' was over 80% for a substantial number of activities, indicating a strong agreement. However, in scoring 'deviations in movements and body posture' the percentage of agreement was insufficient in most activities.
Conclusions: This set of activities has good potential for assessment of the performance of functional activities in children with OBPL. This study, however, showed a number of difficulties in observing and scoring the activities that have to be considered when developing a standardized video observation.