Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test,Action Research Arm Test and Box and Block Test: a multicentre study
Restricted accessResearch articleFirst published online June, 2005
Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test,Action Research Arm Test and Box and Block Test: a multicentre study
Objectives: To establish: (1) inter-rater and test–retest reliability of standardized guidelines for the Fugl-Meyer upper limb section, Action Research Arm Test and Box and Block Test in patients with paresis secondary to stroke, multiple sclerosis or traumatic brain injury and (2) correlation between these arm motor scales and more general measures of impairment and activity limitation.
Design: Multicentre cohort study.
Setting: Three European referral centres for neurorehabilitation.
Subjects: Thirty-seven stroke, 14 multiple sclerosis and five traumatic brain injury patients.
Main measures: Scores of the Fugl-Meyer Test (arm section), Action Research Arm Test, and Box and Block Test derived from video information.
Results: All three motor tests showed very high inter-rater and test–retest reliability (ICC and rho for main variables>0.95). Correlation between the motor scales was very high (rho>0.92). Motor scales correlated moderately highly with the Hemispheric Stroke Scale, a measure of impairment (rho=0.660–0.689), but not with the Modified Barthel Index, a measure of the ability to cope with basic activities of daily living (rho=0.044–0.086).
Conclusions: The standardized guidelines assured comparability of test administration and scoring across clinical facilities. The arm motor scales provided information that was not identical to information from the Hemispheric Stroke Scale or the Modified Barthel Index. Address for correspondence: Priv.-Doz. Dr T Platz, Klinik Berlin, Kladower Damm 223, 14089 Berlin, Germany.
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References
1.
1 Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. Scand J Rehabil Med1975; 7:13–31.
2.
2 WHO. International Classification of Functioning, Disability and Health. Geneva: World Health Organization, 2001.
3.
3 Carroll D. A quantitative test of upper extremity function. J Chronic Disabl1965; 18: 479–491.
4.
4 Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. Int J Rehabil Res1981; 4: 483–492.
6 Mathiowetz V, Volland G, Kashman N, Weber K. Adult norms for the Box-and-Block test of manual dexterity. Am J Occup Ther1985; 39: 386–391.
7.
7 Demeurisse G, Demol O, Robaye E. Motor evaluation in vascular hemiplegia. Eur Neurol1980; 19: 382–389.
8.
8 Ashworth B. Preliminary trial of carisoprodol in multiple sclerosis. Practioner1964, 192: 540–542.
9.
9 Adams RJ, Mador K. Sethi KD, Grotta JC, Thompson DS. Graded neurological scale for use in acute hemispheric stroke treatment protocols. Stroke1987; 18: 665–669.
10.
10 Levin HS, High WM, Goethe KE et al. The neurobehavioral rating scale: assessment of the behavioural sequelae of head injury by the clinician. J Neurol Neurosurg Psychiatry1987, 50: 183–193.
11.
11 Shah S, Vanclay F, Cooper B. Improving the sensitivity of the Barthel Index for stroke rehabilitation. J Clin Epidemiol1989; 42: 703–709.
12.
12 Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology1983; 33: 1444–1452.
13.
13 Bravo G, Potvin L. Estimating the reliability of continuous measures with Cronbach's alpha or the intraclass correlation coefficient: toward the integration of two traditions. J Clin Epidemiol1991; 44: 381–390.
14.
14 Deyo RA, Diehr P, and Patrick DL. Reproducibility and responsiveness of health status measures. Statistics and strategies for evaluation. Control Clin Trials1991; 12: 412–458.
15.
15 Bonett DG. Sample size requirements for estimating intraclass correlations with desired precision. Stat Med2002; 21: 1331–1335.
16.
16 Svensson E. Guidelines to statistical evaluation of data from rating scales and questionnaires. J Rehabil Med2001; 33:47–48.
17.
17 Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet1986; i: 307–310.
18.
18 Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther1983; 63: 1607–1610.
19.
19 Sanford J, Moreland J, Swanson LR, Stratford PW, Gowland C. Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther1993; 73: 447–454.
20.
20 Hsieh C-L, Hsueh I-P, Chiang F-M, P-H Lin. Interrater reliability and validity of the Action Research Arm test in stroke patients. Age Ageing1998; 27: 107–114.
21.
21 van der Lee JH, de Groot V, Beckermann H, Wagenaar RC, Lankhorst GJ, Bouter LM. The intra-and interrater reliability of the Action Research Arm test: a practical test of upper extremity function in patients with stroke. Arch Phys Med Rehabil2001; 82:14–19.
22.
22 Desrosiers J, Bravo G, Hébert R, Dutil E, Mercier L. Validation of the Box-and-Block test as a measure of dexterity of elderly people: reliability, validity, and norms studies. Arch Phys Med Rehabil1994; 75: 751–755.
23.
23 De Weerdt WJG, Harrison MA. Measuring recovery of arm-hand-function in stroke patients: a comparison of the Brunnstrom-Fugl-Meyer test and Action Research Arm test. Physiother Can1985; 37:65–70.
24.
24 Pandyan AD, Johnson GR, Price CIM, Curless RH, Barnes MP, Rodgers H. A review of the properties and limitations of the Ashworth and modified Ashworth Scales as measures of spasticity. Clin Rehabil1999; 13: 373–383.
