Test‐Retest Reliability of the ABILHAND Questionnaire in Persons With Chronic Stroke

Abstract

BackgroundReliable and valid outcome measures are needed to be able to evaluate recovery, effects of rehabilitation interventions, and changes over time. The ABILHAND Questionnaire is a measure of a patient's self‐reported ability to perform complex daily activities involving use of the hand. This instrument is commonly used in stroke rehabilitation settings, but data about the measurement variability are missing.ObjectiveTo assess the test‐retest reliability of the ABILHAND Questionnaire in persons with chronic stroke and to define limits for the smallest change that indicates a real change, both for a group of individuals and for a single individual.DesignA test‐retest reliability study.SettingsUniversity hospital.ParticipantsA convenience sample of 43 persons (11 women and 32 men; mean age 64 years) with mild to moderate impairments of hand function 6‐48 months after sustaining a stroke.InterventionNot applicable.Main Outcome MeasurementsThe ABILHAND Questionnaire is Rasch analyzed, enabling ordinal data to be converted into an interval scale (logits) and the use of parametric statistical analyses. The participants responded to 23 items in the ABILHAND Questionnaire on 2 occasions, 2 weeks apart. Reliability was assessed with the intraclass correlation coefficient (ICC22.1), the mean difference between the test sessions (đ) together with the 95% confidence intervals for đ, the standard error of measurement (SEM and SEM%), the smallest real difference (SRD and SRD%), and a Bland and Altman graph.ResultsFour outliers with high mean logit scores (>4.0) were identified in the sample. The results therefore are presented both for the entire sample (n = 43) and without the 4 outliers (n = 39). The test‐retest agreement was high: ICC2,1 = 0.85 (n = 43) and 0.91 (n = 39). The SEM%, which represents the smallest change that indicates a real improvement for a group of individuals, was 21% (n = 43) and 15% (n = 39). The SRD%, which represents the smallest change that indicates a real clinical improvement for a single individual, was 59% (n = 43) and 42% (n = 39), respectively.ConclusionThe ABILHAND Questionnaire is reliable in persons with chronic stroke and can be recommended to evaluate recovery, rehabilitation interventions, and changes over time in a group of individuals but is less suitable for a single individual.

Perceived ability to perform daily hand activities after stroke and associated factors: a cross-sectional study

“…The higher the logit value, the better the self-perceived ability to use the upper extremities in daily hand activities. In this study, the Swedish version of the ABILHAND was used [23], which has been shown to have acceptable test-retest reliability for persons with mild to moderate impairments of the upper extremities after stroke [8]. Due to cultural differences the item ‘Peeling potatoes with a knife’ was changed to ‘Peeling potatoes’ (as a potato-peeler is commonly used in Sweden) and in the item ‘Tearing open a pack of chips’ the following words were added ‘ or a candy-bag’ (because older persons in Sweden more rarely eat chips) [8].…”

“…The advantage of using questionnaires is that they often provide a better understanding of an individual’s self-reported everyday difficulties and thereby enable clinicians to design more individually targeted rehabilitation interventions [6]. One questionnaire that is recommended for persons with disability of the upper extremity after stroke is the ABILHAND Questionnaire [4, 7, 8]. It assesses self-perceived ability to perform daily bimanual activities.…”

“…It assesses self-perceived ability to perform daily bimanual activities. Previous studies have focused on evaluating the psychometric properties of the ABILHAND [4, 8], but no study has thoroughly described which activities persons in a stable phase post stroke perceive difficult to perform.…”

Reliability of maximal grip strength measurements and grip strength recovery following a stroke

“…Test-retest reliability was excellent when tested in subjects 6 to 48 months post-stroke. 28 In this study, raw scores were converted into logits using online analysis (http://www.rehab-scales.org).…”

Adaptação transcultural do Questionário ABILHAND específico para indivíduos pós-acidente vascular encefálico

“…A vantagem das medidas lineares é que elas podem oferecer resultados cientificamente mais robustos e clinicamente mais significativos do que medidas ordinais, ao permitir inferências corretas a partir de comparações diretas inter ou intraindivíduos 11 . O ABILHAND, específico para indivíduos pós-AVE, foi utilizado em estudos prévios 12,13 e apresentou adequada validade de construto 7 e confiabilidade testereteste 14 . Além disso, pode ser recomendado para uso clínico, por pontuar nove em 10 na escala de utilidade clínica de Tyson e Connell, que avalia o tempo de aplicação, custo, necessidade de equipamento, treinamento especial e portabilidade 15 .…”