ABSTRACT
BACKGROUND AND PURPOSE: The Chedoke Arm and Hand Activity Inventory (CAHAI) is a new, validated upper-limb measure that uses a 7-point quantitative scale in order to assess functional recovery of the arm and hand after a stroke. The purposes of this study were: (1) to determine whether the longitudinal validity of scores on 2 versions of a new upper-limb measure, the CAHAI (CAHAI-9 and CAHAI-13), was greater than that of scores on the Action Research Arm Test (ARAT) and (2) to determine whether the cross-sectional and longitudinal validity of the CAHAI-13 scores was greater than that of the CAHAI-9 scores. SUBJECTS: One hundred five people with upper-limb dysfunction following a stroke were stratified into 2 impairment groups (mild to moderate and severe), which were expected to change by different amounts. METHODS: The CAHAI-13 and ARAT were administered twice (time between assessments varied from 2 to 6 weeks). Receiver operating characteristic curves, Pearson product moment coefficient of correlation, and regression analyses were used. RESULTS: Receiver operating characteristic curve areas (CAHAI-13=0.86, CAHAI-9=0.82, ARAT=0.72) were significantly greater for the CAHAI versions. Scores on both CAHAI versions had identical levels of cross-sectional validity. DISCUSSION AND CONCLUSION: Both CAHAI versions demonstrated more sensitivity to change than the ARAT. It remains unclear whether the CAHAI-9 provides precise estimates of CAHAI-13 scores at the individual level.
Subject(s)
Activities of Daily Living , Arm/physiopathology , Hand/physiopathology , Physical Examination/methods , Severity of Illness Index , Stroke/classification , Stroke/physiopathology , Aged , Cross-Sectional Studies , Female , Geriatric Assessment/methods , Humans , International Classification of Diseases , Longitudinal Studies , Male , Middle Aged , Motor Skills , Observer Variation , Ontario , Physical Examination/standards , Psychometrics , ROC Curve , Recovery of Function , Regression Analysis , Sensitivity and Specificity , Stroke/diagnosis , Stroke Rehabilitation , Time FactorsABSTRACT
The Chedoke Arm and Hand Activity Inventory (CAHAI) was developed to address the need for a valid, clinically relevant, responsive functional assessment of the recovering paretic upper limb. The purpose of this article is to describe the development of the measure including its theoretical constructs, item generation, and item selection. From the literature, survivors of stroke, and their caregivers, 751 items were generated. Using factor analyses stem leaf plots, clinical judgment, and pilot testing on individuals with stroke, the list was reduced to 13 bilateral, real-life items. Research continues to provide evidence of the CAHAI's test-retest and interrater reliability as well as construct, concurrent, and longitudinal validity.
