Rachel Reoli1,2,3, Kendra Cherry-Allen1, Amanda Therrien4, Jennifer Keller3, Kristan Leech5, Abigail Leddy Whitt6, Amy Bastian1,3,7,8. 1. Department of Physical Medicine and Rehabilitation, Johns Hopkins Hospital, Baltimore, Maryland, USA. 2. Department of Rehabilitation Sciences, University of Maryland Baltimore, Baltimore, Maryland, USA. 3. Center for Movement Studies, Kennedy Krieger Institute, Baltimore, Maryland, USA. 4. Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, California, USA. 5. Moss Rehabilitation Research Institute, Elkins Park, Pennsylvania, USA. 6. Inova Fairfax Hospital Health System, Fairfax, Virginia, USA. 7. Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 8. Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.
Abstract
OBJECTIVE: For people with ataxia, there are validated outcome measures to address body function and structure (BFS) impairments and participation; however, no outcome measure exists for upper extremity (UE) activity level in this population. The purpose of this study was to determine whether the action research arm test (ARAT), a measure of UE activity validated for other neurological conditions, might be a useful outcome measure for capturing UE activity limitations in ataxia. METHODS: A total of 22 participants with ataxia were evaluated to assess construct validity of the ARAT; 19 of the participants were included in the interrater reliability assessment. Participants received a neurologic examination and completed a battery of outcome measures, including the ARAT. ARAT performance was video recorded and scored by 4 additional raters. RESULTS: For construct validity, Spearman rho showed a significant moderate relationship between the ARAT and BSF outcome measures. A small, nonsignificant relationship was noted for the ARAT and the participation measure. For interrater reliability, Spearman rho showed a large, significant relationship among all raters for the ARAT (range = .87-.94). High reliability was demonstrated using the intraclass correlation coefficient ([2,1] = .97). CONCLUSION: The ARAT is moderately correlated with ataxia BFS outcome measures, but not with participation scores. The ARAT is a measure of UE activity, which is different from BFS and participation outcome measures. The ARAT was identified to have strong interrater reliability among raters with varying amounts of experience administering the ARAT. Thus, for the ataxic population, the ARAT may be useful for assessing UE activity limitations. IMPACT: Ataxia can negatively affect reaching tasks; therefore, it is important to assess UE activity level in people with ataxia. Until this study, no outcome measure had been identified for this purpose. LAY SUMMARY: People with ataxia may have difficulty with daily tasks that require reaching. The ARAT is an outcome measure that clinicians can use to assess UE activity limitations to help design a treatment program.
OBJECTIVE: For people with ataxia, there are validated outcome measures to address body function and structure (BFS) impairments and participation; however, no outcome measure exists for upper extremity (UE) activity level in this population. The purpose of this study was to determine whether the action research arm test (ARAT), a measure of UE activity validated for other neurological conditions, might be a useful outcome measure for capturing UE activity limitations in ataxia. METHODS: A total of 22 participants with ataxia were evaluated to assess construct validity of the ARAT; 19 of the participants were included in the interrater reliability assessment. Participants received a neurologic examination and completed a battery of outcome measures, including the ARAT. ARAT performance was video recorded and scored by 4 additional raters. RESULTS: For construct validity, Spearman rho showed a significant moderate relationship between the ARAT and BSF outcome measures. A small, nonsignificant relationship was noted for the ARAT and the participation measure. For interrater reliability, Spearman rho showed a large, significant relationship among all raters for the ARAT (range = .87-.94). High reliability was demonstrated using the intraclass correlation coefficient ([2,1] = .97). CONCLUSION: The ARAT is moderately correlated with ataxia BFS outcome measures, but not with participation scores. The ARAT is a measure of UE activity, which is different from BFS and participation outcome measures. The ARAT was identified to have strong interrater reliability among raters with varying amounts of experience administering the ARAT. Thus, for the ataxic population, the ARAT may be useful for assessing UE activity limitations. IMPACT: Ataxia can negatively affect reaching tasks; therefore, it is important to assess UE activity level in people with ataxia. Until this study, no outcome measure had been identified for this purpose. LAY SUMMARY: People with ataxia may have difficulty with daily tasks that require reaching. The ARAT is an outcome measure that clinicians can use to assess UE activity limitations to help design a treatment program.
Authors: T Schmitz-Hübsch; R Fimmers; M Rakowicz; R Rola; E Zdzienicka; R Fancellu; C Mariotti; C Linnemann; L Schöls; D Timmann; A Filla; E Salvatore; J Infante; P Giunti; R Labrum; B Kremer; B P C van de Warrenburg; L Baliko; B Melegh; C Depondt; J Schulz; S Tezenas du Montcel; T Klockgether Journal: Neurology Date: 2010-02-23 Impact factor: 9.910
Authors: Ella M R Fonteyn; Anita Heeren; Jasper-Jan C Engels; Jasper J Den Boer; Bart P C van de Warrenburg; Vivian Weerdesteyn Journal: Gait Posture Date: 2014-04-24 Impact factor: 2.840