Article

OBJECTIVE: To determine the responsiveness of five arm function measures in
people receiving acute inpatient stroke rehabilitation.
DESIGN: Inception cohort
study. SETTING: Comprehensive stroke unit providing early rehabilitation.
SUBJECTS: A total of 64 consecutively admitted stroke survivors with moderately
severe disability (Modified Rankin Scale score median (interquartile range
(IQR)): 4.0 (1.0)). MAIN MEASURES: Responsiveness was analyzed by calculating
effect size, standardized response mean and median-based effect size.
Floor/ceiling effects were calculated as the percentage of participants scoring
the lowest/highest possible scores. RESULTS: Average length of stay and number of
therapy days were 34 (SD = 27.9) and 12 (SD = 13.1), respectively. Box and Block
Test and Functional Independence Measure-Self-Care showed the highest
responsiveness with values in the moderate-large range (effect size = 1.09,
standardized response mean = 1.07 and median-based effect size = 0.76; effect
size = 0.94, standardized response mean = 1.04 and median-based effect size =
1.0). Responsiveness of Action Research Arm Test and Upper Limb-Motor Assessment
Scale were moderate (effect size = 0.58, standardized response mean = 0.69 and
median-based effect size = 0.59; effect size = 0.62, standardized response mean =
0.75 and median-based effect size = 0.67). For Manual Muscle Test, responsiveness
was in the small-moderate range (effect size = 0.42, standardized response mean =
0.59 and median-based effect size = 0.5). Box and Block Test showed the largest
floor effect on admission (28%), and Action Research Arm Test and Manual Muscle
Test showed the largest ceiling effect on discharge (31%). CONCLUSION: These five
measures varied in their ability to detect change with responsiveness ranging
from the small to large range. Box and Block Test and Functional Independence
Measure-Self-Care showed a greater ability to detect change; both demonstrated
moderate-large responsiveness.

Langue : ANGLAIS