Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 6, 2010
   Pages 563 — 572

Abstract —  Responsiveness and validity of three dexterous function measures in stroke rehabilitation

Keh-chung Lin, ScD, OTR;1-2 Li-ling Chuang, PhD, PT;1 Ching-yi Wu, ScD, OTR;3* Yu-wei Hsieh, MS;1Wan-ying Chang, BS4

1School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; 2Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan; 3Graduate Institute of Clinical Behavioral Science and Department of Occupational Therapy, Chang Gung University, Taoyuan, Taiwan; 4Rehabilitation Department, Taipei Hospital, Department of Health, Taipei, Taiwan

Abstract — In this study, we compared the responsiveness and validity of the Box and Block Test (BBT), the Nine-Hole Peg Test (NHPT), and the Action Research Arm Test (ARAT). We randomized 59 patients with stroke into one of three rehabilitation treatments for 3 weeks. We administered six outcome measures (BBT, NHPT, ARAT, Fugl-Meyer Assessment [FMA], Motor Activity Log [MAL], and Stroke Impact Scale [SIS] hand function domain) pretreatment and posttreatment. We used the standardized response mean (SRM) to examine responsiveness and the Spearman rank correlation coefficient (rho) to examine concurrent validity. The BBT, NHPT, and ARAT were moderately responsive to change and not significantly different (SRM = 0.64-0.79). The correlations within the BBT, NHPT, and ARAT were moderate to good at pretreatment (rho = -0.55 to -0.80) and posttreatment (rho = -0.57 to -0.71). The BBT and ARAT showed fair to moderate correlations with the FMA, MAL, and SIS hand function domain at pretreatment and posttreatment (rho = 0.31-0.59), whereas the NHPT demonstrated low to fair correlations with the FMA and MAL (rho = -0.16 to -0.33) and moderate correlations with the SIS hand function domain (rho = -0.58 to -0.66). Our results indicate that the BBT, NHPT, and ARAT are suitable to detect changes over time. While simultaneously considering the responsiveness and validity attributes, the BBT and ARAT can be considered more appropriate for evaluating dexterous function than the NHPT. Further studies with larger samples are needed to validate these findings.

Clinical Trial Registration:; Relative Effects and Predictive Models of Contemporary Upper Limb Training Programs in Stroke Patients; NCT00778453;

Key words: bootstrapping, cerebrovascular accident, clinimetrics, dexterity, function, outcome, rehabilitation, responsiveness, upper limb, validity.

This article and any supplementary material should be cited as follows:
Lin K, Chuang L, Wu C, Hsieh Y, Chang W. Responsiveness and validity of three dexterous function measures in stroke rehabilitation. J Rehabil Res Dev. 2010;47(6):563-72.

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Last Reviewed or Updated  Thursday, August 19, 2010 12:09 PM

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