Article

Objective: To develop an adaptive measure, the Stroke Arm Ladder, to
parsimoniously quantify upper extremity function post stroke. SETTING: Various
studies conducted in Montreal and elsewhere in Canada. Subjects: A total of 4058
persons with stroke who participated in various studies were assessed on
different occasions post stroke. Assessments spanned from 3 days to 1 year post
stroke. Main measures: A calibrated bank containing 49 items from tests and
indices designed to assess global motor recovery of the upper extremity, upper
extremity function and activities involving the upper extremity was used. Data
including all testing occasions were analysed to test whether they adhered to the
expectations of the Rasch partial credit model and whether item hierarchy
remained stable across testing occasions. Results: Fifteen items did not meet the
requirements of the Rasch model and were deleted. An adaptive measure of upper
extremity function, the Stroke Arm Ladder, containing 34 items was created. The
easiest item was partially executing the bilateral task of tying a scarf around
one's neck, while the hardest item was being able to transfer more than 60 blocks
on the Box and Block Test. The items' difficulty thresholds cover a wide range of
difficulty levels from -7.4 to 6.2 and the global fit statistics (chi(2): 331;
probability: 0.18), confirmed content validity. Conclusion: The Stroke Arm Ladder
demonstrates adequate initial psychometric properties. Further testing of the
measure in its adaptive format is necessary before it can be used clinically.

Langue : ANGLAIS