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INTRA- AND INTERRATER RELIABILITY OF THE ACTION RESEARCH ARM TEST IN PATIENTS WITH STROKE

Conference contribution
Authors Åsa Nordin
Published in 7th World Congress of the International Society of Physcial and Rehabilitation Medicine (ISPRM 2013)
Publication year 2013
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Language en
Subject categories Neurology, Physiotherapy

Abstract

Objective: To examine the intra- and interrater reliability of the Action Research Arm Test (ARAT) at item level after stroke. Method: Two experienced physiotherapists simultaneously scored the 19 items of ARAT at two occasions approximately one hour apart. A convenience sample of thirty-four patients participated in the study (mean age 60 years, mean time post-stroke 30 month). The intra- and interrater reliability was tested at item level and the agreement measured with Percentage Agreement (PA). The Svensson’s method for paired ordinal data was applied to identify and measure systematic disagreement in position; Relative Position (RP) and concentration; Relative Concentration (RC), separately from disagreement caused by individual variations; Relative rank Variance (RV). The RP and RC values ranges from -1to 1 (0=no difference, -1/1=large difference), while RV goes from 0 to 1 (RV<0.1=negligible). Results: Good intrarater agreement (PA>80 %) was noted for 16 of the 19 items and good interrater agreement for 13 items. Within the examiners, statistically significant systematic disagreement in position was found for one item (item 11); RP 0.119. Between-examiners, a systematic disagreement in position was found for four items (item 1, 4, 7, 12) with RP ranging from -0.092 to 0.113. For relative concentration, systematic disagreement was found for two items (item 1, 19); RC -0.143 and 0.181. There was no disagreement caused by individual variations (RV≥=0.1) within or between the examiners. Implications/Impact on rehabilitation: ARAT is a reliable rating scale for the upper extremity performance after stroke but training of examiners is highly recommended before use.

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