Development of a New Daily Activities Scale for the Affected Hand after Stroke

Abstract

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.

Restoring Upper Limb Function by Combined Repetitive Transcranial Magnetic Stimulation and Occupational Therapy in Patients with Chronic Stroke: A Stratified Analysis Factoring the Severity of Motor Paralysis using a Multicenter Cohort Study Database

“…For the target daily activities, it is suggested to use the function of the proximal part of the upper limb to press a plate, paper, or a book on a desk, a task that includes inward movement of the forearm. Similarly, even in the case of reduced hand dexterity, if patients can reach their own body, they can aim to acquire movements such as pressing an upper garment when opening and closing a zipper, washing the upper limb and fingers of the non-paralyzed side, stretching wrinkles of clothes, and removing dust from clothes [37,38].…”