The Adult Assisting Hand Assessment Stroke: Psychometric Properties of an Observation-Based Bimanual Upper Limb Performance Measurement

Gils, Annick Van; Meyer, Sarah; Dijk, Margaretha van; Thijs, Liselot; Michielsen, Marc; Lafosse, Christophe; Truyens, Veronik; Oostra, Kristine; Peeters, André; Thijs, Vincent; Feys, Hilde; Krumlinde‐Sundholm, Lena; Kos, Daphne; Verheyden, Geert

doi:10.1016/j.apmr.2018.04.025

Cited by 10 publications

(17 citation statements)

References 37 publications

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“…A higher unit indicates higher ability. Ad-AHA produce a valid measure of bimanual performance 4,5 with good to excellent interrater and intrarater reliability for patients with subacute stroke 5 . In this study, each task was performed at least once by each patient and tasks were alternated between assessment occasions.…”

Section: Main Outcome Assessmentmentioning

confidence: 99%

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Recovery and Prediction of Bimanual Hand Use After Stroke

et al. 2021

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Objective:To determine similarities and differences in key predictors of recovery of bimanual hand use and unimanual motor impairment after stroke.Method:In this prospective longitudinal study n = 89 first-ever stroke patients with arm paresis, were assessed at 3 weeks, 3 and 6 months after stroke onset. Bimanual activity performance was assessed with the Adult Assisting Hand Assessment Stroke (Ad-AHA), unimanual motor impairment with the Fugl-Meyer Assessment (FMA). Candidate predictors included shoulder abduction and finger extension measured by the corresponding FMA-items (FMA-SAFE, range 0-4) and sensory and cognitive impairment. MRI was used to measure weighted corticospinal tract lesion load (wCST-LL) and resting-state interhemispheric functional connectivity (FC).Results:Initial Ad-AHA performance was poor but improved over time in all (mild-severe) impairment subgroups. Ad-AHA correlated with FMA at each time-point (r>0.88, p<0.001) and recovery trajectories were similar. In patients with moderate-severe initial FMA, FMA-SAFE was the strongest predictor of Ad-AHA outcome (R2 = 0.81) and degree of recovery (R2 = 0.64). Two-point discrimination explained additional variance in Ad-AHA outcome (R2 = 0.05). Repeated analyses without FMA-SAFE identified wCST-LL and cognitive impairment as additional predictors. A wCST-LL above 5.5cc strongly predicted low-to-minimal FMA/Ad-AHA recovery (≤10/20p, specificity = 0.91). FC only explained some additional variance to FMA-SAFE in unimanual recovery.Conclusion:Although recovery of bimanual activity depends on the extent of CST injury and initial sensory and cognitive impairments, FMA-SAFE captures most of the variance explained by these mechanisms. FMA-SAFE, a straightforward clinical measure, strongly predicts bimanual recovery.Classification of Evidence:This study provides Class I evidence that the FMA-SAFE predicts bimanual recovery after stroke.

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Section: Main Outcome Assessmentmentioning

confidence: 99%

“…One accelerometerbased study has indicated increased bimanual hand use, during the first 3 months after stroke 3 . Impaired inter-limb coordination 4 and grip force matching between hands 5 have also been reported.…”

Section: Introductionmentioning

confidence: 99%

Recovery and Prediction of Bimanual Hand Use After Stroke

et al. 2021

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“…The ICC was calculated for total scores. ICC is classified as high (more than 0.90), moderate (between 0.75 and 0.90), and low (less than 0.75) (17). To assess the reliability, standard error measurement (SEM) and ICC were used.…”

Section: Discussionmentioning

confidence: 99%

Psychometric Properties of the Persian Version of Children's Sleep Comic

2021

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Background: Insomnia is one of the most common sleep problems among children and is associated with a wide variety of impairments such as aggression, decreased attention and concentration, daytime sleepiness, hyperactivity, and irritability. A child with insomnia can affect the whole family. It is important to assess insomnia and sleep behaviors of children because insomnia is not a common diagnosis in them. Children’s Sleep Comic is a questionnaire to diagnose insomnia in children aged 5-11 years, which can be completed within 20 minutes. Objectives: The aim of the present study was to translate and investigate the Persian form of Children’s Sleep Comic's content validity and reliability. Methods: This cross-sectional study was carried out on 209 children aged 5-11 years in primary schools and preschools of Tehran who were selected by random cluster sampling in 2019. The translation was done with the forward-backward method. The content validity was evaluated by 10 occupational therapists, and quantitative content validity was determined by calculating the Content Validity Index (CVI) and Content Validity Ratio (CVR). Internal consistency was assessed through Cronbach’s alpha and test-retest reliability via Intraclass Correlation Coefficient (ICC) among 30 children after one week as well as Standard Error of Measurement (SEM). Results: Overall, 220 children were entered into the study; however, 11 children were excluded because of missing data. The translation of Children's Sleep Comic was considered easy and acceptable. The content validity, which was assessed by CVR and CVI were desirable (0.8 and 0.8, respectively), and the internal consistency was 0.76. ICC and SEM were 0.97 and 0.02, respectively. Conclusions: The findings of this study showed that the Persian version of the Children's Sleep Comic questionnaire is a reliable and valid instrument that can be used for screening insomnia in Iranian children aged 5-11 years.

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“…A 1–4 category rating scale was used to score the more affected limb on all 19 components: (1) does not do; (2) ineffective; (3) somewhat effective; and (4) effective. The Ad-AHA Stroke has established validity and reliability in individuals post stroke [ 25 ]. All ratings were completed by an experienced and certified rater.…”

Section: Methodsmentioning

confidence: 99%

Quantifying intra- and interlimb use during unimanual and bimanual tasks in persons with hemiparesis post-stroke

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Miller

Quinn

et al. 2022

J NeuroEngineering Rehabil

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Background Individuals with hemiparesis post-stroke often have difficulty with tasks requiring upper extremity (UE) intra- and interlimb use, yet methods to quantify both are limited. Objective To develop a quantitative yet sensitive method to identify distinct features of UE intra- and interlimb use during task performance. Methods Twenty adults post-stroke and 20 controls wore five inertial sensors (wrists, upper arms, sternum) during 12 seated UE tasks. Three sensor modalities (acceleration, angular rate of change, orientation) were examined for three metrics (peak to peak amplitude, time, and frequency). To allow for comparison between sensor data, the resultant values were combined into one motion parameter, per sensor pair, using a novel algorithm. This motion parameter was compared in a group-by-task analysis of variance as a similarity score (0–1) between key sensor pairs: sternum to wrist, wrist to wrist, and wrist to upper arm. A use ratio (paretic/non-paretic arm) was calculated in persons post-stroke from wrist sensor data for each modality and compared to scores from the Adult Assisting Hand Assessment (Ad-AHA Stroke) and UE Fugl-Meyer (UEFM). Results A significant group × task interaction in the similarity score was found for all key sensor pairs. Post-hoc tests between task type revealed significant differences in similarity for sensor pairs in 8/9 comparisons for controls and 3/9 comparisons for persons post stroke. The use ratio was significantly predictive of the Ad-AHA Stroke and UEFM scores for each modality. Conclusions Our algorithm and sensor data analyses distinguished task type within and between groups and were predictive of clinical scores. Future work will assess reliability and validity of this novel metric to allow development of an easy-to-use app for clinicians.

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The Adult Assisting Hand Assessment Stroke: Psychometric Properties of an Observation-Based Bimanual Upper Limb Performance Measurement

Cited by 10 publications

References 37 publications

Recovery and Prediction of Bimanual Hand Use After Stroke

Recovery and Prediction of Bimanual Hand Use After Stroke

Psychometric Properties of the Persian Version of Children's Sleep Comic

Quantifying intra- and interlimb use during unimanual and bimanual tasks in persons with hemiparesis post-stroke

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