Article

PURPOSE: To develop a patient reported outcome measure of active and passive
function in the hemiparetic upper limb. METHODS: Potential items for inclusion
were identified through (a) systematic review and analysis of existing measures
and (b) analysis of the primary goals for treatment in a spasticity service. Item
reduction was achieved through consultation with a small, purposively selected
multi-disciplinary group of experienced rehabilitation professionals (n = 10) in
a three-round Delphi process. This was followed by a confirmatory survey with a
larger group of clinicians (n = 36) and patients and carers (n = 13 pairs).
RESULTS: From an initial shortlist of 75 items, 23 items were initially
identified for inclusion in the arm activity measure (ArmA), and subsequently
refined to a 20-item instrument comprising 7 passive and 13 active function. In
common with the six measures identified in the systematic review, a five-point
ordinal scaling structure was chosen, with ratings based on activity over the
preceding 7 days. CONCLUSIONS: The ArmA is designed to measure passive and active
function following focal interventions for the hemiparetic upper limb. Content
and face validity have initially been addressed within the development process.
The next phase of development has involved formal evaluation of psychometric
properties. IMPLICATIONS FOR REHABILITATION: In clinical practice or research,
outcome measures in rehabilitation need to have face and content validity.
Following stroke or brain injury, goals for rehabilitation of the hemiparetic
upper limb may be: to restore active function, if there is return of motor
control or to improve passive function making it easier to care for the limb
(e.g. maintain hygiene) if no motor return is possible, measurement of both
constructs should be considered. This study describes the systematic development
of the ArmA, a measure of active and passive function in the hemiparetic upper
limb.

Langue : ANGLAIS