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Evidence-Based Rating of Upper-Extremity Motor Function Tests Used for People Following a Stroke

E Croarkin, PT, MPT, NCS, is Neurological Clinical Specialist, Physical Therapy Section, National Institutes of Health, Bldg 10, Room 6S-235, 9000 Rockville Pike, Bethesda, MD 20892-1604 (Usa) (ecroarkin{at}cc.nih.gov).
J Danoff, PT, PhD, is Research Consultant, Physical Therapy Section, National Institutes of Health, and Associate Professor, Department of Exercise Science, George Washington University Medical Center
C Barnes, PT, MSPT, is Contract Physical Therapist, Broaddus Hospital, Philippi, WVa. At the time of data collection, Ms Barnes was a student intern at the National Institutes of Health

Address all correspondence to Mrs Croarkin

Introduction. Tests of upper-extremity motor function used for people following a stroke have been described, but reliability and validity (psychometric properties) of measurements obtained with these tests have not been consistently established. This investigation was performed: (1) to review literature relative to upper-extremity motor function testing during rehabilitation following a stroke, (2) to develop selection criteria for identifying these tests in the literature, and (3) to rate the tests relative to their psychometric properties. Method. Literature searches were done using 2 databases. Reports of 4 psychometric properties were sought: interrater reliability, test-retest reliability, convergent validity or concurrent validity, and predictive validity. Results. Nine tests met the inclusion criteria of having psychometric properties reported in the literature. No test had evidence for all 4 psychometric properties. Only the Nine-Hole Peg Test was supported by 3 out of 4 properties. Most tests had 2 properties supported. Concurrent validity or convergent validity was most frequently described; test-retest reliability was least frequently described. Conclusions. More complete psychometric support is needed for upper-extremity motor function tests applied following a stroke. The absence of psychometric support, however, does not mean that a test has no value. Clinicians are cautioned not to generalize psychometric evidence.

Key Words: Evidence-based rating • Motor function tests • Stroke • Upper extremity

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