Objectives: There are few scales that reflect the function of the stroke-affected arm as it relates to the performance of daily activities while also indicating the difficulty of scale items. In this study, we developed the Activities Specific Upper-extremity Hemiparesis Scale (ASUHS) to evaluate daily activities performable by the affected arm after stroke. We also clarified the validity, reliability, and item difficulty of the scale. Methods: The participants were 145 patients with stroke who were consecutively admitted to a convalescent rehabilitation ward. The unidimensionality of ASUHS was assessed by principal component analysis. Analyses of item discrimination and content validity were conducted to assess the overall validity. Reliability was evaluated by assessing internal consistency and inter-rater reliability. Item difficulties were determined by Rasch analysis. Results: Unidimensionality, high discrimination, and good content validity were shown for all items. ASUHS consists of a dominant hand scale and non-dominant hand scale. Both scales showed good internal consistency (Cronbach’s α coefficient = 0.99) and substantial inter-rater reliability (Cohen’s Kappa coefficient = 0.74 and 0.75, respectively). Item difficulty was determined as being in the range –8.71 to +5.18 logit. Conclusions: This study suggested good validity and reliability of ASUHS. Furthermore, because the item difficulties of daily activities performed by the affected arm were clarified, therapists can use ASUHS to identify the process that should be the next focus for training. Consequently, therapists may be able to train patients in daily activities that match the affected arm’s ability step by step rather than determining training activities empirically.

Objectives: It is difficult to predict behavioral disturbances in patients with Alzheimer's dementia because the order of appearance of behaviors is not clear. This study aimed to clarify the difficulty of the Dementia Behavior Disturbance Scale (DBDS) sub-items in patients with Alzheimer's disease and to compare changes in behavioral disorders after 6 months. Methods: The participants were inpatients with Alzheimer-type dementia hospitalized in participating hospitals for more than a year. They were assessed with the DBDS, the Mini-Mental State Examination (MMSE), and the Functional Independence Measure (FIM) twice: at the initial assessment and after 6 months. Rasch analysis for the sub-items of the DBDS determined the difficulty of behavioral disturbances. Results: The participants were 44 inpatients. There was no significant difference in the DBDS, MMSE, and FIM between the initial assessment and that after 6 months. Even though many participants increased or decreased for each assessment scale, there was no major change in the order of item difficulty of DBDS between the initial assessment and after 6 months. Conclusions:The systematic indication of the difficulty of behavioral disturbances in the DBDS is a new finding. It is possible to rank the difficulty of sub-items of the DBDS and infer behavioral disturbances that are likely to appear in the future. This is useful for clinical decision-making in dementia rehabilitation and care because it indicates the predictability of signs of dementia and behavioral disturbances that suggest the need for dementia intervention.

In this article, the Table in the Appendix has been corrected. Item numbers in the Table correspond to the item numbers shown in Figure 3. It is possible to correctly interpret the order of the item difficulty calculated using Rasch analysis, by comparing Figure 3 and the Table in the Appendix. The authors apologize for this error. The correct Table reads as follows. Corrected points are in red.