Quality Of Upper Extremity Skills Test Research Articles

Exploring the comparative responsiveness of a core set of outcome measures in a school‐based conductive education programme

Conductive education (CE) is a holistic educational system that uses an active cognitive approach to teach individuals with motor disorders to become more functional participants in daily activities. While CE's popularity continues to grow in North America and Europe, its effectiveness has not been established. The lack of definition of responsive outcome measures for evaluation of CE programmes has limited the interpretability of conclusions from earlier studies evaluating effectiveness. To determine which measures from a core set were most responsive to physical, functional and psychosocial changes associated with a school-based CE programme. This was a one-group before and after data collection design using an 8-month follow-up period. We enrolled a referral sample of nine children with cerebral palsy in Kindergarten or Grade 1 (Gross Motor Function Classification System levels 3, 4 or 5). The study took place within a school-based CE programme at a Canadian children's rehabilitation centre. Children participated in a CE full-day class for an entire school year. Physical, functional, psychosocial and participation measures included: Gross Motor Function Measure (GMFM), Quality of Upper Extremity Skills Test (QUEST), Peabody Developmental Motor Scales, Paediatric Evaluation of Disability Inventory (PEDI), Pictorial Scale of Perceived Competence and Social Acceptance for Young Children, Individualized Educational Plan, and Goal Attainment Scaling (GAS). Four children from the study's second year were also evaluated on the Impact on Family Scale (IFS), GAS and School Function Assessment. The Gross Motor Function Measure, QUEST, PEDI (Caregiver Assistance) and IFS were most responsive to change. GAS was useful in documenting and quantifying goals. Problems were encountered in evaluating self-esteem and school participation. Several strong measures of outcome were identified. Further work is needed to find valid and sensitive psychosocial and school participation measures for these young children.

The Use of Lycra Garments in Children with Cerebral Palsy: A Report of a Descriptive Clinical Trial

This study aimed to evaluate the effects of wearing Lycra garments in children with cerebral palsy. Eight participants, aged 3 years 5 months to 13 years (male = 4, female = 4) and with a diagnosis of cerebral palsy, were recruited. A repeated measures design was used, with participants tested with the Gross Motor Function Measure (GMFM) and the Quality of Upper Extremity Skills Test (QUEST) before and after intervention. Both parents and participants recorded the perceived advantages and disadvantages of the participant wearing the Lycra garment at the end of the trial. Each participant received a baseline test, was then provided with a Lycra garment and was re-tested once wear time was more than 4 hours per day. Four participants withdrew from the trial (discomfort from suit, n = 3; prescribed spinal jacket, n = 1). Of the remaining four participants, all showed an improvement in either GMFM or QUEST score and one showed improvement in both test scores. All but one of the eight participants recorded functional improvements when wearing their suit. In this population, the participants showed improvements in function when wearing a Lycra garment, but problems with discomfort remained a barrier for some children to their more sustained use.

Test/Retest Reliability and Inter-Rater Agreement of the Quality of Upper Extremities Skills Test (QUEST) for Older Children with Acquired Brain Injuries

Test/Retest Reliability and Inter-Rater Agreement of the Quality of Upper Extremities Skills Test (QUEST) for Older Children with Acquired Brain Injuries

The use of virtual reality to improve upper-extremity efficiency skills in children with cerebral palsy: A pilot study

This paper presents the results of a pilot study of a virtual reality play based intervention. The results of four single case studies are presented. The virtual reality intervention used the Mandala Gesture Xtreme technology. It was applied to four school aged children with cerebral palsy. A pretest-posttest design was used. The relevant outcome of interest was upper extremity control as measured with the Quality of Upper Extremity Skills Test (QUEST), item #6 of Subtest #5 of the Bruininks-Oseretsky Test of Motor Proficiency (BOTMP), and a measure of percent accuracy . The total scores on the QUEST indicated clinically significant changes in quality of upper extremity for two of the children. Changes were noted in other measures of upper extremity control for each child. Qualitative comments from the participants revealed a high degree of motivation, interest, pleasure, and opportunity for engage- ment in play activities not previously engaged in. Overall, this pilot study suggests the viability of a virtual reality play based intervention as part of the rehabilitation process for children with cerebral palsy. These results will form the basis of a larger scale randomized clinical trial.

Test/Retest Reliability and Inter-Rater Agreement of the Quality of Upper Extremities Skills Test (QUEST) for Older Children with Acquired Brain Injuries

Test/retest reliability and inter-rater agreement was established on the Quality of Upper Extremities Skills Test (QUEST) for 16 children between 6 and 16 years of age who had an acquired brain injury. Performance on the QUEST was videotaped for the purpose of scoring, and some modifications were made to the administration and scoring of the assessment. Intra-class correlation indicated high agreement for test/retest reliability (0.90 to 0.95), and inter-rater reliability (0.84 to 0.94) across all subtests. The findings are discussed in terms of ongoing test refinements and the extension of the original age range and diagnostic group for which the test was designed.

An evaluation of botulinum-A toxin injections to improve upper extremity function in children with hemiplegic cerebral palsy

Objective: In a randomized, controlled, single-blind trial, to test the hypothesis that botulinum-A toxin (BTA) injections into the upper extremity of children with spastic hemiplegia improve upper extremity function. Study design: Thirty children with hemiplegia, aged 2.5 to 10 years, were randomly assigned to receive: (1) a BTA injection into 1 or more of 3 muscle groups (biceps, volar forearm muscles, adductor pollicis) plus occupational therapy or (2) occupational therapy alone. Blinded outcomes obtained at baseline and at 1, 3, and 6 months included the Quality of Upper Extremity Skills Test (QUEST), goniometry measurements, grip strength, and Ashworth scores. The caregiver completed the self-care domain of the Pediatric Evaluation of Disability Inventory. Results: Twenty-nine subjects completed the study. The QUEST demonstrated a significant improvement favoring the treatment group on a 2-way analysis of variance (F = 4.69, df = 1,83; P =.039). BTA treatment was also associated with an improvement in score on the self-care domain of the Pediatric Evaluation of Disability Inventory (F = 4.68, df = 1,82; P =.04). Conclusions: This study supports the effectiveness of BTA injections to improve upper extremity function of children with hemiplegia who have at least moderate spasticity. (J Pediatr 2000;137:331-7)

Botulinum toxin A in cerebral palsy: Functional outcomes

Botulinum toxin A in cerebral palsy: Functional outcomes

Upper Extremity Performance and Self-Care Skill Changes in Children with Spastic Cerebral Palsy following Selective Posterior Rhizotomy

Changes in upper extremity and self-care performance following selective posterior rhizotomy (SPR) are reported frequently, but rarely quantified. In this study, 36 children with spastic cerebral palsy were assessed preoperatively and 1 year following SPR using the Quality of Upper Extremity Skills Test (QUEST). Twenty-six children were assessed at similar intervals using the Functional Independence Measure for Children (WeeFIM) as a measure of self-care performance. Wilcoxon matched-pair signed-rank tests were used to compare the QUEST total scores and the WeeFIM motor, cognitive, and total scores before and after SPR. One year after SPR, the total QUEST scores were significantly better (median improvement = 3.2%, p < 0.0001), as were the WeeFIM motor (median improvement = 9.5, p < 0.0001), cognitive (median improvement = 1.0, p < 0.008), and total (median improvement = 11.0, p < 0.0001) scores. The results indicate quantifiable improvements in upper extremity function, and motor and cognitive self-care skills in children 1 year after SPR.

A Review of the Quality of Upper Extremities Skills Test (QUEST) for Children with Cerebral Palsy

A Review of the Quality of Upper Extremities Skills Test (QUEST) for Children with Cerebral Palsy

A Review of the Quality of Upper Extremities Skills Test (QUEST) for Children with Cerebral Palsy

Disorder of movement is the main feature of cerebral palsy. Yet, until recently, no easy-to-use validated measure of upper limb quality of movement has been available for children with cerebral palsy. The Quality of Upper Extremities Skills Test (QUEST) was developed to meet this need. The QUEST was developed for children aged 18 months to 8 years and this review finds that initial reliability and validity data are promising. The ability of the test to detect change, however, is less clear and there is little support for its discriminative properties. Some suggestions are made regarding administration and scoring procedures. Notwithstanding these limitations, the QUEST is identified as an important first step to the measurement of upper extremity quality of movement for children with cerebral palsy.

The Reliability and Validity of the Quality of Upper Extremity Skills Test

The Quality of Upper Extremity Skills Test (QUEST) was developed to overcome limitations of currently available measures of hand function. This measure evaluates quality of upper extremity function in four domains: dissociated movement, grasp, protective extension, and weight bearing. It is designed to be used with children who have neuromotor dysfunction with spasticity and has been validated with children from 18 months to 8 years of age. Recently, a multi-centre trial evaluating the effect of neurodevelopmental therapy (NDT) and upper extremity casting on improvement of hand function in children with cerebral palsy was completed. Data collected during that study were analyzed to examine the validity and responsiveness of the QUEST. Consensus meetings were held with therapists who have used the QUEST, reliability testing was completed and a manual of test administration was written. The results of these studies indicate that the QUEST is a criterion referenced measure with good interobserver and test-retest reliability. The QUEST correlates strongly with another measure of hand function, the Peabody Developmental Fine Motor Scales. The QUEST is useful as a measure to describe upper extremity quality of movement and to use in planning intervention programs.

The Reliability and Validity of the Quality of Upper Extremity Skills Test

The Quality of Upper Extremity Skills Test (QUEST) was developed to overcome limitations of currently available measures of hand function. This measure evaluates quality of upper extremity function in four domains: dissociated movement, grasp, protective extension, and weight bearing. It is designed to be used with children who have neuromotor dysfunction with spasticity and has been validated with children from 18 months to 8 years of age. Recently, a multi-centre trial evaluating the effect of neurodevelopmental therapy (NDT) and upper extremity casting on improvement of hand function in children with cerebral palsy was completed. Data collected during that study were analyzed to examine the validity and responsiveness of the QUEST. Consensus meetings were held with therapists who have used the QUEST, reliability testing was completed and a manual of test administration was written. The results of these studies indicate that the QUEST is a criterion referenced measure with good interobserver and test-retest reliability. The QUEST correlates strongly with another measure of hand function, the Peabody Developmental Fine Motor Scales. The QUEST is useful as a measure to describe upper extremity quality of movement and to use in planning intervention programs.