The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.

<h4>Importance</h4>To efficiently perform bimanual daily tasks, bimanual coordination is needed. Bimanual coordination is the interaction between an individual's hands, which may be impaired post-stroke, however clinical and functional assessments are lacking and research is limited...

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Main Authors: Debbie Rand, Nitsan Omer, Amihai Levkoviz, Samar Assadi Khalil
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0316356
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author Debbie Rand
Nitsan Omer
Amihai Levkoviz
Samar Assadi Khalil
author_facet Debbie Rand
Nitsan Omer
Amihai Levkoviz
Samar Assadi Khalil
author_sort Debbie Rand
collection DOAJ
description <h4>Importance</h4>To efficiently perform bimanual daily tasks, bimanual coordination is needed. Bimanual coordination is the interaction between an individual's hands, which may be impaired post-stroke, however clinical and functional assessments are lacking and research is limited.<h4>Objectives</h4>To develop a valid and reliable observation tool to assess bimanual coordination of individuals post-stroke.<h4>Design</h4>A cross-sectional study.<h4>Setting</h4>Rehabilitation settings.<h4>Participants</h4>Occupational therapists (OTs) with stroke rehabilitation experience and individuals post stroke.<h4>Outcomes and measures</h4>The development and content validity of BOTH included a literature review, review of existing tools and followed a 10-step process. The conceptual and operational definitions of bimanual coordination were defined as well as scoring criteria. Then multiple rounds of feedback from expert OTs were performed. OTs reviewed BOTH using the 'Template for assessing content validity through expert judgement' questionnaire. Then, BOTH was administered to 51 participants post-stroke. Cronbach's alpha was used to verify internal reliability of BOTH and construct validity of BOTH was assessed by correlating it to the bimanual subtests of The Purdue Pegboard Test.<h4>Results</h4>Expert validity was established in two-rounds with 11 OTs. Cronbach's alpha was α = 0.923 for the asymmetrical items, 0.897 for the symmetrical items and 0.949 for all eight items. The item-total correlations of BOTH were also strong and significant. The total score of BOTH was strongly significantly correlated with The Purdue-Both hands placement (r = .787, p < .001) and Assembly (r = .730, p < .001) subtests.<h4>Conclusions and relevance</h4>BOTH is a new observation tool to assess bimanual coordination post-stroke. Expert validity of BOTH was established, excellent internal reliability and construct validity were demonstrated. Further research is needed, so in the future, BOTH can be used for clinical and research purposes to address bimanual coordination post-stroke.
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spelling doaj-art-3e37b0b84e714bdda6c2998ad782fc3e2025-01-17T05:31:39ZengPublic Library of Science (PLoS)PLoS ONE1932-62032025-01-01201e031635610.1371/journal.pone.0316356The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.Debbie RandNitsan OmerAmihai LevkovizSamar Assadi Khalil<h4>Importance</h4>To efficiently perform bimanual daily tasks, bimanual coordination is needed. Bimanual coordination is the interaction between an individual's hands, which may be impaired post-stroke, however clinical and functional assessments are lacking and research is limited.<h4>Objectives</h4>To develop a valid and reliable observation tool to assess bimanual coordination of individuals post-stroke.<h4>Design</h4>A cross-sectional study.<h4>Setting</h4>Rehabilitation settings.<h4>Participants</h4>Occupational therapists (OTs) with stroke rehabilitation experience and individuals post stroke.<h4>Outcomes and measures</h4>The development and content validity of BOTH included a literature review, review of existing tools and followed a 10-step process. The conceptual and operational definitions of bimanual coordination were defined as well as scoring criteria. Then multiple rounds of feedback from expert OTs were performed. OTs reviewed BOTH using the 'Template for assessing content validity through expert judgement' questionnaire. Then, BOTH was administered to 51 participants post-stroke. Cronbach's alpha was used to verify internal reliability of BOTH and construct validity of BOTH was assessed by correlating it to the bimanual subtests of The Purdue Pegboard Test.<h4>Results</h4>Expert validity was established in two-rounds with 11 OTs. Cronbach's alpha was α = 0.923 for the asymmetrical items, 0.897 for the symmetrical items and 0.949 for all eight items. The item-total correlations of BOTH were also strong and significant. The total score of BOTH was strongly significantly correlated with The Purdue-Both hands placement (r = .787, p < .001) and Assembly (r = .730, p < .001) subtests.<h4>Conclusions and relevance</h4>BOTH is a new observation tool to assess bimanual coordination post-stroke. Expert validity of BOTH was established, excellent internal reliability and construct validity were demonstrated. Further research is needed, so in the future, BOTH can be used for clinical and research purposes to address bimanual coordination post-stroke.https://doi.org/10.1371/journal.pone.0316356
spellingShingle Debbie Rand
Nitsan Omer
Amihai Levkoviz
Samar Assadi Khalil
The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
PLoS ONE
title The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
title_full The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
title_fullStr The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
title_full_unstemmed The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
title_short The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation.
title_sort bimanual observation of the hands both development reliability and validity for stroke rehabilitation
url https://doi.org/10.1371/journal.pone.0316356
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