Comparing 2 Versions of the Chedoke Arm and Hand Activity Inventory With the Action Research Arm Test

Abstract

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.]

Os instrumentos de avaliação de atividade dos membros superiores contemplam as tarefas mais realizadas em domicílio por pessoas com hemiparesia?

“…In this study, the tasks of IADL identified as being more frequent were holding a light object and using the remote control of the TV/tablet/cellular, being the first task most performed with the paretic UL, contemplated in TEMPA (MICHAELSEN et al, 2008). Nevertheless, the second activity involves some movement components of the task of typing on a telephone of the CAHAI instrument (BARRECA et al, 2006), which requires greater manual and digital skills. However, this task was performed primarily with non-paretic UL.…”

“…Regarding the assessment instruments with a greater number of tasks similar to IADL, the MAL, MAM-36 and now TEMPA are highlighted again, considering that the instruments of perceived performance usually bring a greater number of evaluated items and consequently, they can have a greater chance of representing more tasks performed in the home environment. However, both TEMPA and CAHAI are instruments that stand out because they have relevant tasks and, although they require different materials and a trained evaluator for their application, they are simple tasks to be carried out in daily life (BARRECA et al, 2006;CHEN;BODE, 2010;MICHAELSEN et al, 2008;PEREIRA et al, 2012;SALIBA et al, 2011). In TEMPA, the number of tasks contemplated exceeded the number of tasks evaluated in the instrument, because the tasks evaluated are sequential, that is, they involve several actions within the same task, such as the task of taking a jar, serving water and carrying the glass to the mouth (MICHAELSEN et al, 2008).…”

“…The ABILHAND, AMAT, CAHAI, MAL, MAM-16, and MAM-36 tests show some tasks related to the subcategories "personal hygiene" and "clothing". However, none of them question, for example, the tasks related to hygiene after using the toilet, which is a task that requires the involvement of the upper limbs (BARRECA et al, 2006;BASÍLIO et al, 2016;CHEN;BODE, 2010;CHEN et al, 2005;KOOP et al, 1997;PEREIRA et al, 2012;SALIBA et al, 2011). The functional independence measure (FIM) assesses the level of independence for these activities, that despite bringing relevant daily tasks, this instrument does not assess the level of activity of the upper limbs specifically (RIBERTO et al, 2001).…”

“…UL according to the action performed as stabilizer or manipulator; (4) the Jebsen-Taylor hand function test, which presents seven daily unilateral activities, involving grasping, holding, and manipulating objects objectively and rapidly, with emphasis only on manual function; (5) TEMPA, composed of eight standardized unilateral and bilateral tasks that simulate daily activities, and (6) WMFT, which presents 17 tasks that combine time and quality of execution measures of movement in isolated movements of specific joints as well in the context of complex functional tasks (BARRECA et al, 2006;HACKEL et al, 1992;MORLIN et al, 2006;MICHAELSEN et al, 2008;PAZ;BORGES, 2007;PEREIRA et al, 2011).…”

“…The relevance of the items assessed in the instruments of UL activity can be verified by asking the target population to judge the importance of the tasks (BARRECA et al, 1999) or by identifying the main tasks actually performed by an individual in a real-life situation, that is, at home (KILBREATH; HEARD, 2005). Due to the great variety of tasks performed in activities of daily living that require the use of the upper limbs and to better contemplate this range of tasks, the assessment instruments of UL activity after a stroke include assessing a multiplicity of daily tasks (BARRECA et al, 2006;HACKEL et al, 1992;MICHAELSEN et al, 2008;PAZ;BORGES, 2007;PENTA et al, 2001;PEREIRA et al, 2011).…”