Hammersmith Infant Neurological Examination Clinical Use to Recommend Therapist Assessment of Functional Hand Asymmetries

Abstract

Purpose: To determine whether asymmetry scores derived from the Hammersmith Infant Neurological Examination (HINE) can provide cutoff scores for recommending in-depth assessment of upper extremity functional deficits by therapists using the Hand Assessment for Infants (HAI). Methods: Observational study in a clinical laboratory with the HINE and the HAI administered concurrently to 101 infants 3 to 12 months corrected age developing typically or atypically. Predictive value of HINE asymmetry scores for atypical HAI was determined. Results: Total HINE asymmetry scores of 4 or greater had 100% sensitivity and 88% or greater specificity for identifying infants with an asymmetric HAI score of 3 or greater point difference between hands. Conclusions: For infants receiving a total HINE asymmetry score of 4 or greater, referral to therapists for HAI assessment may be beneficial to precisely evaluate function and determine the need for targeted upper extremity interventions. (Pediatr

Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination

“…In relation to the different subsections, to our knowledge, this is the first study that collects the reliability results for the registration of asymmetries, based on recent recommendations regarding the importance of their registration in the context of evaluation with HINE for the early detection of unilateral CP [24,25]. The good intra-examiner reliability presented by the asymmetries in the Spanish version (ICC = 0.96) contrasts with the moderate values of reliability (ICC = 0.58), which could suggest the need to incorporate descriptors that establish unified criteria for the score of asymmetries in each item of the tool, also highlighting those identified in the literature with a higher correlation with unilateral CP.…”