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Oxford Gait Laboratory

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Upper limb

Children with upper limb involvement face many challenges in their daily life.

Activities such as dressing, feeding, using the shower and toilet, and writing (just to name a few) are often hindered or even impossible to perform with a less functional hand. Good hand function and position are therefore important for an independent life.

We offer two video assessments for upper limb function:

Assisting Hand Assessment (AHA)

The AHA measures how the affected arm and hand are used in bimanual performance by observing the child's spontaneous handling of toys.

The AHA is validated for children aged between 18 months and 12 years with hemiplegic cerebral palsy, obstetric brachial plexus palsy and upper limb reduction deficiency.

For more detailed information about the AHA please refer to the AHA website.

Shriners Hospitals for Children Upper Extremity Evaluation (SHUEE)

The SHUEE analyses the spontaneous use and position of the hand and arm joints by observing the child’s performance during defined tasks.

The SHUEE is validated and useful for children aged between seven and 18 years with hemiplegic cerebral palsy

For more detailed information about the SHUEE please refer to:

Davids et al. (2006). Validation of the Shriners Hospital for Children Upper Extremity Evaluation (SHUEE) for children with hemiplegic cerebral palsy. JBJS. 88, 326-333

Both assessments are used to guide treatment such as:

  • physiotherapy, i.e. constraint induced movement therapy
  • occupational therapy
  • orthotic provision
  • botulinum toxin injections
  • surgery.

The upper limb assessment at Oxford Gait Laboratory includes a thorough clinical examination, including assessment of ranges of motion, contractures, muscle strength and spasticity.

The performance of the affected upper limb in the AHA and/or SHUEE is interpreted in relation to the clinical examination before treatment recommendations are made.

Last reviewed:21 August 2023