Article

OBJECTIVE: To evaluate the psychometric properties of the Arm Activity Measure
(ArmA), a patient-reported measure of active and passive function in the paretic
upper limb. DESIGN: Psychometric evaluation study. SETTING: Two specialist
rehabilitation and spasticity management services.
METHOD: Patients (n = 92) with
upper limb paresis were recruited from two specialist neurorehabilitation
centres. Mean age 44.5 (SD 16.7). Diagnostic distribution: stroke 48 (52%); other
brain injury 28 (31%); or other neurological condition 16 (17%). Evaluation of
convergent and divergent validity; unidimensionality, scaling, reliability
(internal consistency and test-retest); responsiveness to change and feasibility
of the ArmA were undertaken. RESULTS: Expected convergent and divergent
relationships were seen with the Leeds Adult Spasticity Impact Scale and the
Disabilities of Arm Shoulder and Hand (DASH) (rho 0.5-0.63). Principal components
analysis confirmed that active and passive function formed two separate
constructs in each sub-scale. Mokken analysis corroborated the findings of the
principal components analysis and demonstrated scaling using the monotone
homogeneity model (Item H>0.5 for all items). Cronbach's alpha was 0.85 and 0.96,
respectively, for the passive and active function subscales. Item level
test-retest agreement ranged from 92-97.5% (quadratic-weighted Kappa 0.71-0.94).
In the subgroup treated for spasticity with botulinum toxin (n = 58), the ArmA
passive function scale identified a significant difference between responder and
non-responder groups (Mann Whitney U = 0.85, p < 0.01). Respondents reported the
ArmA to be relevant (77%), easy to use (90%) and timely to complete (83% under 10
minutes). CONCLUSION: The ArmA is a valid and reliable tool feasible for use in
the evaluation of upper limb function in the context of treatment for spasticity.

Langue : ANGLAIS