A simple bedside test for upper extremity impairment after stroke: Validation of the Utrecht Arm/Hand Test

Abstract

Purpose. To examine the intra- and inter-rater reliability, criterion validity and responsiveness of the Utrecht Arm/hand Test (UAT), a quick and easy assessment method for upper extremity impairment after stroke.

Method. Study 1 (N = 29): Repeated administration of the UAT at admission and discharge; comparison with scores on the Fugl-Meyer test (FM), Action Research Arm test (ARA) and Self-Care scale of the Functional Independence Measure (FIM). Study 2 (N = 192): Admission of the UAT and Frenchay Arm Test at admission (FAT) and discharge. Computation of Spearman correlations between UAT and FAT and comparison of the Effect Size and the Standardised Response Mean of both measures.

Results. Study 1: Spearman correlations between UAT and FM were 0.93 at admission and 0.94 at discharge. Correlations with ARA and FIM were also high: 0.90 and 0.76 at admission, and 0.89 and 0.73 at discharge. Inter-rater and intra-rater reliability were excellent (weighted κ 0.98–0.99). Study 2: Correlations between UAT and FAT were 0.93 at admission and 0.90 at discharge. The mean UAT score improved from 3.7 at admission up to 4.6 at discharge (p < 0.001). The Effect Size and Standardised Response Mean of the UAT were better than those of the FAT.

Conclusion. The UAT is a simple, valid and reliable bedside test for the evaluation of upper extremity impairment after stroke.

Keywords:

• Stroke
• assessment
• motor activity
• outcome assessment
• arm
• rehabilitation