The Intra-Rater Reliability and Validity of Action Reach Arm Test for Stroke Patients

Abstract

Background: The Action Research Arm Test (ARAT) can provide subjective results due to the difficulty assessing abnormal patterns in stroke patients. Objective: To determine the intra-rater reliability and validity of the Action Reach Arm Test (ARAT) in patients recovering from stroke. Study Design: An intra-rater and inter-rater reliability study. Settings: Department of physical therapy, University Teaching hospital, University of Lahore, Lahore Pakistan. Duration: Between January 2018- December 2018. Methods: Sixty participants (47 men and 13 women, mean age 57.78 ± 13.37 (35-77) years with a mean time after stroke 8.76 ± 14.86 (0.5–80) months with poor upper extremity function after stroke were included in the study. To examine the intra-rater reliability of action research arm test, the rater re-assessed 36 out of the 60 participants on next day. Intra-class correlation coefficients (ICCs) were used to analyze the intra-rater reliability. Upper limb function was also assessed by Fugl-Meyer Assessment concurrent with ARAT on the same day. The validity was measured by using Inter-class correlation coefficient test. The validity of the test was examined by comparing the patient’s score on ARAT score and those obtained through Fugl-Meyer Assessment score. Results: The ICCs of the total, grasping, gripping, pinching, and gross movement scores received were 0.980, 0.975, 0.995, and 0.935 (all p < 0.001) respectively, indicate excellent intra-rater reliability. Thus, ARAT appeared to be a stable assessment tool. The scores of ARAT closely correlated with upper limb function Fugl-Meyer Assessment score. The high intra-rater reliability and validity of the Action Research Arm Test (ARAT) was confirmed. Conclusion: The preliminary results of this study support the value of the ARAT for measuring recovery of arm-hand function in stroke patients.