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Title: The Adult Assisting Hand Assessment Stroke: Psychometric properties of an observation-based bimanual upper-limb performance measurement.
Austin Authors: Van Gils, Annick;Meyer, Sarah;Van Dijk, Margaretha;Thijs, Liselot;Michielsen, Marc;Lafosse, Christophe;Truyens, Veronik;Oostra, Kristine;Peeters, Andre;Thijs, Vincent N ;Feys, Hilde;Krumlinde-Sundholm, Lena;Kos, Daphne;Verheyden, Geert
Affiliation: KU Leuven - University of Leuven, Department of Rehabilitation Sciences, Leuven, Belgium
University Hospitals Leuven, Leuven, Belgium
Jessa Hospital - Rehabilitation Centre Sint Ursula, Herk-de-stad, Belgium
Rehabilitation Hospital RevArte, Edegem, Belgium
Rehabilitation and MS Centre Overpelt, Overpelt, Belgium
Ghent University Hospital, Ghent, Belgium
Cliniques universitaires Saint-Luc, Brussels, Belgium
The Florey Institute of Neuroscience and Mental Health, Heidelberg, Victoria, Australia
Neuropediatric Research Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
Austin Health, Heidelberg, Victoria, Australia
Issue Date: 2018 2018-05-25
Publication information: Archives of Physical Medicine and Rehabilitation 2018; 99(12): 2513-2522
Abstract: To investigate interrater and intrarater reliability, measurement error and convergent and discriminative validity of the Adult Assisting Hand Assessment Stroke (Ad-AHA Stroke). Cross-sectional observational study SETTING: Seven stroke rehabilitation centers PARTICIPANTS: A total of 118 stroke survivors (reliability sample: n=30; validity sample: n=118) were included (median age 67 years (interquartile range (IQR) 59-76); median time post stroke 81 days (IQR 57-117). N/A. Ad-AHA Stroke, Action Research Arm Test (ARAT), Upper Extremity Fugl-Meyer assessment (UE-FMA). The Ad-AHA Stroke is an observation-based instrument assessing the effectiveness of the spontaneous use of the affected hand when performing bimanual activities in adults after stroke. Reliability of Ad-AHA stroke was examined using intraclass correlation coefficients (ICC), Bland-Altman plots, and weighted kappa (Kw) statistics for reliability on item level. Standard error of measurement (SEM) was calculated based on Ad-AHA units. Convergent validity was assessed by calculating Spearman rank correlation coefficients between Ad-AHA stroke and ARAT and UE-FMA. Comparison of Ad-AHA stroke scores between subgroups of patients according to hand dominance, neglect and age evaluated discriminative validity. Intrarater and interrater agreement showed an ICC of 0.99 (95% CI=0.99-0.99), a SEM of 2.15 and 1.64 out of 100, respectively and Kw for item scores were all above 0.79. The relation between Ad-AHA and other clinical assessments was strong (rs=0.9). Patients with neglect had significantly lower Ad-AHA scores compared to patients without neglect (p=0.004). The Ad-AHA Stroke captures actual bimanual performance. Thereby it provides an additional aspect of upper limb assessment with good to excellent reliability and low SEM for patients with sub-acute stroke. High convergent validity with ARAT and UE-FMA and discriminative validity was supported.
DOI: 10.1016/j.apmr.2018.04.025
ORCID: 0000-0002-6614-8417
PubMed URL: 29807004
Type: Journal Article
Subjects: Stroke
Outcome assessment
Task performance
Upper extremity
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