Conceptualisation and development of the arm activity measure (ArmA) for assessment of activity in the hemiparetic arm

Figures & data

Figure 1. Summary of item reduction for the ArmA.

Table 1.  Initial short list of passive and active function items (round 1), mapped back onto the systematic review measures why?

Functional items	Patient identified	LASIS	MAL-14	MAL-26	MAL-28	MAL-12	ABILHAND	Proximal, distal and whole arm
Splint application	*							Whole arm
Positioning the arm comfortably	*							Whole arm
Putting on a glove		*						Distal
Cutting fingernails		*						Distal
Cleaning the armpit		*						Proximal
Cleaning the palm		*		*				Distal
Putting arm through coat  sleeve or dressing the arm		*	*	*				Whole arm
Eat with a knife and fork			*	*	*	*		Whole arm
Pick up a glass, bottle, or can			*	*	*	*	*	Whole arm
Brush teeth			*	*	*	*	*	Whole arm
Use a key to unlock the door+			*	*			*	Whole arm
Comb hair			*	*	*	*	*	Whole arm
Pick up a cup by the handle			*	*		*		Distal
Write on paper					*	*		Distal
Carry an object in the hand			*	*				Whole arm
Dial a number on the phone				*	*		*	Distal
Open a jar						*	*	Distal
Pick up phone					*			Whole arm
Put on T-shirt							*	Whole arm
Do or undo buttons on clothing				*			*	Distal
Do or undo a zip				*			*	Distal
Drink from cup/mug							*	Whole arm
Wash your back							*	Whole arm

Items in bold indicate those retained at the end of round 3 of item reduction – modified Delphi consensus. Item marked with a + was initially excluded. Asterisks indicate that the item is included in the measure.

Table 2.  Demographic information of patients (n = 13) and carers (n = 13).

	Characteristics	Patients	Carers
Age of patients (years)	Median (range)	48.5 (30–64)	–
Gender	Male	8 (62%)	–
	Female	5 (38%)	–
Ethnicity	White	10 (77%)	–
	Black	1 (8%)	–
	Asian	2 (15%)	–
Primary pathology	Haemorrhagic stroke	5 (38%)	–
	Ischaemic stroke	8 (62%)	–
Questionnaire  completion method	Face to face	8 (62%)	3 (23%)
	Postal return	4 (31%)	7 (54%)
	Telephone	1 (8%)	3 (23%)

Carers: spouse or family (not professional carers).

Table A1.  ArmA items.

Difficulty for each item is scored over the proceeding 7 d as follows

0 = No difficulty

1 = Mild

2 = Moderate

3 = Severe difficulty

4 = Unable to do activity

Section A: Caring for your affected arm (not using it in tasks or activities)

1. Cleaning the palm of the hand

2. Cutting finger nails

3. Cleaning the armpit

4. Cleaning the elbow crease*

5. Positioning arm on a cushion or support in sitting (if never done circle 0)

6. Putting arm through a garment sleeve

7. Putting on a glove (if never done circle 0)

8. Putting on a splint (if never done circle 0)

Section B: Independently completing tasks or activities using your affected arm

1. Do up buttons on clothing

2. Pick up a glass, bottle, or can

3. Use a key to unlock the door

4. Write on paper

5. Open a previously opened jar

6. Eat with a knife and fork

7. Hold an object still while using unaffected hand

8. Difficulty with balance when walking due to your arm

9. Dial a number on home phone

10. Tuck in your shirt

11. Comb or brush your hair

12. Brush your teeth

13. Drink from a cup or mug

*Item inserted following preliminary psychometric testing reported in a subsequent paper. The ArmA is freely available to use and can be obtained from the King's College London, Department of Palliative Care, Policy and Rehabilitation, web site (http://www.csi.kcl.ac.uk/arma.html).