Article

Functional limitation of the upper extremities is common in patients
with stroke. An upper-extremity measure with sound psychometric properties is
indispensable for clinical and research use.
The purpose of this study
was to compare the psychometric properties of 4 clinical measures for assessing
upper-extremity motor function in people with stroke : the upper-extremity
subscale of the Fugl-Meyer Motor Test (UE-FM), the upper-extremity subscale of
the Stroke Rehabilitation Assessment of Movement, the Action Research Arm Test
(ARAT), and the Wolf Motor Function Test. DESIGN: This was a prospective,
longitudinal study. METHODS: Fifty-three people with stroke were evaluated with
the 4 measures at 4 time points (14, 30, 90, and 180 days after stroke).
Thirty-five participants completed all of the assessments. The ceiling and floor
effects, validity (concurrent validity and predictive validity), and
responsiveness of each measure were examined. Interrater reliability and
test-retest reliability also were examined. RESULTS: All measures, except for the
UE-FM, had significant floor effects or ceiling effects at one or more time
points. The Spearman rho correlation coefficient for each pair of the 4 measures
was > or =.81, indicating high concurrent validity. The predictive validity of
the 4 measures was satisfactory (Spearman rho, > or =.51). The responsiveness of
the 4 measures at 14 to 180 days after stroke was moderate (.52 < or = effect
size < or = .79). The 4 measures had good interrater reliability (intraclass
correlation coefficient [ICC], > or =.92) and test-retest reliability (ICC, > or
=.97). Only the minimal detectable changes of the UE-FM (8% of the highest
possible score) and the ARAT (6%) were satisfactory. Limitations: The sample size
was too small to conduct data analysis according to type or severity of stroke.
In addition, the timed component of the Wolf Motor Function Test was not used in
this study. CONCLUSIONS:
All 4 measures showed sufficient validity,
responsiveness, and reliability in participants with stroke.
The UE-FM for
assessing impairment and the ARAT for assessing disability had satisfactory
minimal detectable changes, supporting their utility in clinical settings.

Langue : ANGLAIS