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Purpose: To estimate the reliability and validity of three shortened versions of the Chedoke Arm and Hand Activity Inventory (CAHAI). Method: The study sample consisted of 39 individuals who had had a stroke. Twenty-four individuals were classified as acute and 15 as chronic. The CAHAI-13 was administered three times: an initial assessment, a second assessment within 36 hours, and a final assessment two to six weeks after the initial assessment. The Action Research Arm Test (ARAT) and the Chedoke-McMaster Stroke Assessment were administered at the first and third time points. Based on the clinical judgment of four therapists, seven-, eight-, and nine-item versions of the CAHAI were produced. Test–retest reliability and cross-sectional and longitudinal validity (sensitivity to change) were evaluated. Results: Test–retest reliability varied from 0.96 for the CAHAI-7 to 0.97 for the CAHAI-8 and CAHAI-9. Cross-sectional validity for the ARAT was 0.95, 0.95, and 0.94, and longitudinal validity was 0.97, 0.93, and 0.94 for the seven-, eight-, and nine-item versions of the CAHAI, respectively. Conclusions: All shortened versions maintained the same high degree of reliability and construct and longitudinal validity as the original CAHAI-13. Therapists and researchers may select from three valid, shorter versions of a new upper limb functional measure to facilitate effective standardized assessment within limited time and resources.

Background and Purpose. The Chedoke Arm and Hand Activity Inventory (CAHAI) is a new, validated upper-limb measure that uses a 7-point quantitative scale in order to assess functional recovery of the arm and hand after a stroke. The purposes of this study were: (1) to determine whether the longitudinal validity of scores on 2 versions of a new upper-limb measure, the CAHAI (CAHAI-9 and CAHAI-13), was greater than that of scores on the Action Research Arm Test (ARAT) and (2) to determine whether the cross-sectional and longitudinal validity of the CAHAI-13 scores was greater than that of the CAHAI-9 scores. Subjects. One hundred five people with upper-limb dysfunction following a stroke were stratified into 2 impairment groups (mild to moderate and severe), which were expected to change by different amounts. Methods. The CAHAI-13 and ARAT were administered twice (time between assessments varied from 2 to 6 weeks). Receiver operating characteristic curves, Pearson product moment coefficient of correlation, and regression analyses were used. Results. Receiver operating characteristic curve areas (CAHAI-13=0.86, CAHAI-9=0.82, ARAT=0.72) were significantly greater for the CAHAI versions. Scores on both CAHAI versions had identical levels of cross-sectional validity. Discussion and Conclusion. Both CAHAI versions demonstrated more sensitivity to change than the ARAT. It remains unclear whether the CAHAI-9 provides precise estimates of CAHAI-13 scores at the individual level. [Barreca SR, Stratford PW, Masters LM, et al. Comparing 2 versions of the Chedoke Arm and Hand Activity Inventory with the Action Research Arm Test. Phys Ther. 2006;86:245–253.]

BackgroundPhysical rehabilitation is an area where robotics could contribute significantly to improved motor return for individuals following a stroke. This paper presents the results of a preliminary randomized controlled trial (RCT) of a robot system used in the rehabilitation of the paretic arm following a stroke.MethodsThe study's objectives were to explore the efficacy of this new type of robotic therapy as compared to standard physiotherapy treatment in treating the post-stroke arm; to evaluate client satisfaction with the proposed robotic system; and to provide data for sample size calculations for a proposed larger multicenter RCT. Twenty clients admitted to an inpatient stroke rehabilitation unit were randomly allocated to one of two groups, an experimental (robotic arm therapy) group or a control group (conventional therapy). An occupational therapist blinded to patient allocation administered two reliable measures, the Chedoke Arm and Hand Activity Inventory (CAHAI-7) and the Chedoke McMaster Stroke Assessment of the Arm and Hand (CMSA) at admission and discharge. For both groups, at admission, the CMSA motor impairment stage of the affected arm was between 1 and 3.ResultsData were compared to determine the effectiveness of robot-assisted versus conventional therapy treatments. At the functional level, both groups performed well, with improvement in scores on the CAHAI-7 showing clinical and statistical significance. The CAHAI-7 (range7-49) is a measure of motor performance using functional items. Individuals in the robotic therapy group, on average, improved by 62% (95% CI: 26% to 107%) while those in the conventional therapy group changed by 30% (95% CI: 4% to 61%). Although performance on this measure is influenced by hand recovery, our results showed that both groups had similar stages of motor impairment in the hand. Furthermore, the degree of shoulder pain, as measured by the CMSA pain inventory scale, did not worsen for either group over the course of treatment.ConclusionOur findings indicated that robotic arm therapy alone, without additional physical therapy interventions tailored to the paretic arm, was as effective as standard physiotherapy treatment for all responses and more effective than conventional treatment for the CMSA Arm (p = 0.04) and Hand (p = 0.04). At the functional level, both groups performed equally well.