Sage Journals: Discover world-class research

Abstract

Objective : To investigate the construct validity and unidimensionality of the Rivermead Motor Assessment, arm section, using Rasch analysis which transforms the ordinal scale into an interval scale with hierarchical ordering of items.

Setting : Twelve stroke units and rehabilitation centres across Belgium, Germany and Switzerland.

Subjects : Two hundred fifty-two stroke patients, average (SD) age of 63.5 (13.22) years.

Main measures : Principal component analysis on the Rasch data gave additional information on unidimensionality. Differential item functioning established the stability of items for gender, age, country, hemiplegic side, stroke type, and time since stroke.

Results : Four items did not meet the requirements for the Rasch model and were removed. These were `Lying, protract shoulder with arm in elevation', `Pick up tennis ball from table, release on midthigh, return to table, release', `Same exercise with pencil' and `Pick up piece of paper from table. Release five times'. Principal component analysis of the remaining 11 items revealed two dimensions in the scale, `static and dynamic control of movement', and `coordination'. All items were stable among the subgroups of the sample.

Conclusion : The Rivermead Motor Assessment, revised arm section meets the required criteria for validity and unidimensionality. It consists of 11 individual items, which yield two subtotals of overall upper limb ability of the patients. It is a valid tool to evaluate upper limb function after stroke.

Get full access to this article

View all access options for this article.

References

Olsen TS Arm and leg paresis as outcome predictors in stroke rehabilitation . Stroke 1990; 21: 247—51 .

Zorowitz RD Neurorehabilitation of the stroke survivor . Neurorehabil Neural Repair 1999; 13: 83—92 .

De Wit L. , Putman K. , Dejaeger E. et al. Use of time by stroke patients: a comparison of four European rehabilitation centers . Stroke 2005; 36: 1977—83 .

Lincoln N. , Leadbitter D. Assessment of motor function in stroke patients . Physiotherapy 1979; 65: 48—51 .

van Vliet PM , Lincoln NB , Foxall A. Comparison of Bobath based and movement science based treatment for stroke: a randomised controlled trial . J Neurol Neurosurg Psychiatry 2005; 76: 503—508 .

Meldrum D. , Pittock SJ , Hardiman O. et al. Recovery of the upper limb post ischaemic stroke and the predictive value of the Orpington Prognostic Score . Clin Rehabil 2004; 18: 694—702 .

Thielman GT , Dean GM , Gentile AM Rehabilitation of reaching after stroke: task-related training versus progressive resistive exercise . Arch Phys Med Rehabil 2004; 85: 1613—18 .

Hesse S. , Schulte-Tigges G. , Konrad M. et al. Robot-assisted arm trainer for the passive and active practice of bilateral forearm and wrist movements in hemiparetic subjects . Arch Phys Med Rehabil 2003; 84: 915—20 .

Woldag H. , Hummelsheim H.

Is the reduction of spasticity by botulinum toxin a beneficial for the recovery of motor function of arm and hand in stroke patients?

Eur Neurol 2003; 50: 165—71 .

10.

Rousseaux M. , Kozlowski O. , Froger I. Efficacy of botulin toxin A in upper limb function of hemiplegic patients . J Neurol 2002; 249: 76—84 .

11.

Scheidtmann K. , Fries W. , Müller F. et al. Effect of levodopa in combination with physiotherapy on functional motor recovery after stroke: a prospective, randomised, double-blind study . Lancet 2001; 358: 787—90 .

12.

Lincoln NB , Parry RH , Vass CD Randomized, controlled trial to evaluate increased intensity of physiotherapy treatment of arm function after stroke . Stroke 1999; 30: 573—79 .

13.

Parry RH , Lincoln NB , Vass CD Effect of severity of arm impairment on response to additional physiotherapy early after stroke . Clin Rehabil 1999; 13: 187—98 .

14.

Adams SA , Asburn A. , Pickering RM et al. The scalability of the Rivermead Motor Assessment in acute stroke patients . Clin Rehabil 1997; 11: 42—51 .

15.

Adams SA , Pickering RM , Ashburn A. et al. The scalability of the Rivermead Motor Assessment in non-acute stroke patients . Clin Rehabil 1997; 11: 52—59 .

16.

Bond TG , Fox CM Applying the Rasch model. Fundamental measurement in the human sciences. Lawrence Erlbaum Associates , 2001.

17.

Rasch G. Probabilistic models for some intelligence and attainment tests. Mesa Press , 1980.

18.

The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. WHO MONICA Project Principal Investigators . J Clin Epidemiol 1988; 41: 105—14 .

19.

Stucki G. , Daltroy L. , Katz JN et al. Interpretation of change scores in ordinal clinical scales and health status measures: The whole may not equal the sum of parts . J Clin Epidemiol 1996; 49: 711—17 .

20.

Tesio L. Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research . J Rehabil Med 2003; 35: 105—15 .

21.

Andrich D. , Lyne A. , Sheridan B. et al. RUMM 2020 version 4.0 for Windows. Getting started, displaying and extending RUMM2020. RUMM Laboratory Pty Ltd , 2004.

22.

Bhakta B. , Tennant A. , Horton M. , Lawton G. , Andrich D. Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education . BMC Med Educ 2005; 5: 9 .

23.

Andrich D. Recognising a violation of the assumption of local independence in the analysis of test data . Educ Psychol Measurement 1983 ; 43: 829—33 .

24.

Andrich D. A latent trait model for items with response dependencies: implications for test construction and analysis. In Embretson S ed. Test design: Contributions from psychology, education and psychometrics. Academic Press , 1985 : 245—73.

Assessment of arm function in stroke patients: Rivermead Motor Assessment arm section revised with Rasch analysis

Abstract

Get full access to this article

References