Can quality of movement be measured? Rasch analysis and inter-rater reliability of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES)

Abstract

The MESUPES-arm and MESUPES-hand meet the statistical properties of reliability, validity and unidimensionality. Both tests provide a useful clinical and research tool to qualitatively evaluate arm and hand function during recovery after stroke.

Application of Virtual Reality in Neuro-Rehabilitation: An Overview

“…More recently, Trotti and colleagues proposed VR-supported training as an integration of the conventional rehabilitation protocols (Trotti et al, 2009). They used kinematics indexes (such as movement execution time and precision) and validated clinical scales, such as Nine-Hole Peg Test (NHPT) (Mathiowetz, 1985), Frenchay Arm Test (FAT) (Heller, 1987), Medical Research Council (MRC) (Florence, 1992), Motricity Index (MI) (Bohannon, 1999), and the Motor Evaluation Scale for Upper extremity in Stroke Patients (MESUPES) ( Van de Winckel, 2006) to measure the upper limb impairment in a patient with stroke before and after therapy with VR-supported upper limb rehabilitation. Kinematic analysis and most clinical scales (MRC of fingers, MESUPES and NHPT time, but not MI and FAT) showed a decrease in movement execution time and increase in precision, with improved muscle strenght and movement control (Trotti et al, 2009).…”

Measurement properties of the Motor Evaluation Scale for Upper Extremity in Stroke patients (MESUPES)

“…In order to evaluate rehabilitative interventions, therapists need accurate and reliable measurements which also capture the movement quality. Although achieving good quality of movement is proclaimed as an important goal in modern stroke rehabilitation there are few appropriate measures to evaluate this in the upper extremity [4][5][6]. The existing measurements usually have a quantitative approach (for example measures time to perform a movement, the number of possible repetitions of a movement, and active range of motion) without identifying whether the movement is similar to premorbid movements or whether the action occurs through compensatory movements.…”

“…This approach has been used in the development of the new assessment tool, the Motor Evaluation Scale of Upper Extremity in Stroke Patients (MESUPES) [8][9][10]. This is a scale that purportedly measures quality of movement of the hemiparetic upper extremity and it was translated by Van de Winckel et al from its' original Italian version into English in collaboration with the original authors [6]. The MESUPES was then also investigated for internal construct validity and unidimensionality by using Rasch analysis on 398 patients from Belgium, Germany and Switzerland.…”

“…The MESUPES was divided into two sub scales: the MESUPES-arm test and the MESUPES-hand test. The MESUPES showed no different item functioning across gender, age, country of residence, side of lesion, and type of stroke or time since onset of the stroke [6]. Further, 56 patients were randomly selected for a study of reliability.…”

“…Further, 56 patients were randomly selected for a study of reliability. According to Van de Winckel et al [6], the MESUPES met the statistical requirement for validity and relative reliability. However, absolute reliability was not addressed in their study despite that it is nowadays recommended to include measures of both relative and absolute reliability when reporting psychometric properties of new scales [11,12].…”