Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination
Abstract
:1. Introduction
2. Materials and Methods
2.1. Description of HINE
2.2. Cross-Cultural Translation and Adaptation
2.3. Participants
2.4. Evaluation of Intra- and Inter-Examiner Reliability
2.5. Training Program and Development of the Recommendation Guidelines for Evaluation with HINE in Spanish
2.6. Statistical Analysis
3. Results
3.1. Cross-Cultural Translation and Adaptation
3.2. Participants
3.3. Evaluation of Intra- and Inter-Examiner Reliability
3.4. Evaluation of Implementation and Inter-Examiner Reliability One Year after the Training Program
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Training Elements | Duration |
---|---|
Reading the scientific literature supporting the use of HINE | 30 min |
Review of the administration and scoring of individual HINE items | 45 min |
HINE demonstrations with video recordings and face-to-face assessments (different ages and health statuses) | 15 min per patient |
Review of video recordings and discussion of HINE administration and scoring | 20 min per patient |
Item | Subsection | Possible Comprehension Errors |
---|---|---|
Auditory response | Cranial nerves | The Spanish translation should clarify the concept of “dubious reaction” to the stimulus. |
Hands | Posture | In the Spanish translation, there should be the concept of “fisting”. |
Quality | Movements | In the Spanish translation, there should be a word conceptually equivalent to “spasmodic”. |
Lateral suspension | Reflexes and reactions | The Spanish translation should make it clear that the movement is “towards” the horizontal, not in the full horizontal position. |
Characteristic | Total Study Population (n = 25) |
---|---|
Gestational age mean (SD) (minimum, maximum), wks | 30.3 (4.5) (24.4–41.0) |
Birth weight mean (SD) (minimum, maximum), g | 1512.6 (741.1) (720–3450) |
Head circumference, mean (SD) (minimum, maximum), cm | 27.8 (4.1) (21.5–35) |
Apgar 1′ mean (SD) (minimum, maximum); Apgar 1′ mean (SD) (minimum, maximum) | 6.5 (1.9) (2–9); 8.1 (1.6) (4–10) |
Multiple birth, n (%) | 8 (32) |
Preterm birth (<37 wks gestation), n (%) | 23 (92) |
HIE, n (%) | 1 (4) |
BPD, n (%) | 2 (8) |
Major brain pathologies in neuroimaging a, n (%) | 3 (12) |
Age at HINE assessment mean (SD) (minimum, maximum), mo | 8.8 (3.0) (3.5–15.0) |
3 to 5 mo, n (%) | 4 (16) |
6 to 8 mo, n (%) | 9 (36) |
9 to 15 mo, n (%) | 12 (48) |
Intra-Examiner Reliability | Cranial Nerves | Posture | Movements | Tone | Reflexes and Reactions | Asymmetries | Total Score |
---|---|---|---|---|---|---|---|
MR-M | 0.904 | 0.955 | 0.980 | 0.918 | 0.972 | 0.959 | 0.981 |
<0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | |
Inter-Examiner Reliability | |||||||
MR-R, AH-R | 0.817 | 0.818 | 0.990 | 0.868 | 0.914 | 0.507 | 0.968 |
<0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.003 | <0.001 | |
MR-R, JM-A | 0.854 | 0.868 | 0.794 | 0.970 | 0.888 | 0.451 | 0.975 |
<0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.050 | <0.001 | |
AH-R, JM-A | 0.786 | 0.832 | 0.816 | 0.868 | 0.867 | 0.489 | 0.976 |
<0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.037 | <0.001 | |
MR-R, AH-R, JM-A | 0.870 | 0.887 | 0.903 | 0.936 | 0.924 | 0.583 | 0.982 |
<0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.001 | <0.001 |
Inter-Examiner Reliability MR-R, AH-R | Cranial nerve function | Facial appearance | Eye movements | Visual response | Auditory response | Sucking/swallowing | |||
0.359 | 0.468 | 0.490 | 0.917 | 0.370 | |||||
0.022 | 0.001 | 0.004 | <0.001 | 0.006 | |||||
Posture | Head | Trunk | Arms | Hands | Legs | Feet | |||
0.419 | 0.596 | 0.648 | 0.259 | 0.545 | 0.527 | ||||
0.006 | <0.001 | 0.001 | 0.080 | <0.001 | <0.001 | ||||
Movements | Quantity | Quality | |||||||
0.684 | 0.855 | ||||||||
<0.001 | <0.001 | ||||||||
Tone | Scarf sign | Passive shoulder elevation | Pronation/supination | Hip adductors | Popliteal angle | Ankle dorsiflexion | Pull to sit | Ventral suspension | |
0.658 | 0.648 | 0.648 | 0.468 | 0.552 | 0.416 | 0.779 | 0.795 | ||
<0.001 | 0.001 | 0.001 | 0.006 | 0.001 | 0.007 | <0.001 | <0.001 | ||
Reflexes and reactions | Arm protection | Vertical suspension | Lateral tilting | Forward parachute | Tendon reflexes | ||||
0.627 | 0.172 | 0.663 | 0.631 | 0.479 | |||||
<0.001 | 0.380 | <0.001 | <0.001 | 0.001 |
Inter-Examiner Reliability | Cranial Nerves | Posture | Movements | Tone | Reflexes and Reactions | Asymmetries | Total Score |
---|---|---|---|---|---|---|---|
AH-R, IA-G, CB-M, AMF-T | 0.945 | 0.973 | 0.790 | 0.856 | 0.980 | 0.618 | 0.988 |
Total score | <0.001 | <0.001 | <0.001 | <0.001 | <0.001 | 0.026 | <0.001 |
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Hidalgo-Robles, Á.; Merino-Andrés, J.; Rodríguez-Fernández, Á.L.; Gutiérrez-Ortega, M.; León-Estrada, I.; Ródenas-Martínez, M. Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination. Healthcare 2024, 12, 380. https://doi.org/10.3390/healthcare12030380
Hidalgo-Robles Á, Merino-Andrés J, Rodríguez-Fernández ÁL, Gutiérrez-Ortega M, León-Estrada I, Ródenas-Martínez M. Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination. Healthcare. 2024; 12(3):380. https://doi.org/10.3390/healthcare12030380
Chicago/Turabian StyleHidalgo-Robles, Álvaro, Javier Merino-Andrés, Ángel Luis Rodríguez-Fernández, Mónica Gutiérrez-Ortega, Irene León-Estrada, and Maribel Ródenas-Martínez. 2024. "Reliability, Knowledge Translation, and Implementability of the Spanish Version of the Hammersmith Infant Neurological Examination" Healthcare 12, no. 3: 380. https://doi.org/10.3390/healthcare12030380