Motricity index pdf

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Academia.edu uses cookies to personalize content, tailor ads and improve the user experience. By using our site, you agree to our collection of information through the use of cookies. To learn more, view our Privacy Policy. Objective: The aim of this study was to determine whether the arm subscore of the Motricity Index 1 wk after stroke can predict
recovery of upper limb function according to the Action Research Arm Test before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up. Design: This was a prospective cohort study of patients with acute ischemic stroke admitted to a single acute care hospital and affiliated inpatient rehabilitation facility between 2016 and 2018.
Upper limb dexterity of the impaired limb was assessed using the arm subscore of the Motricity Index and Action Research Arm Test. Receiver operating characteristic curve analysis was used to determine optimal cutoffs of the initial arm subscore of the Motricity Index for a good functional outcome defined as Action Research Arm Test score of 45
or higher.
Results: Ninety-five patients were evaluated at median 6, 26, and 98.5 days after stroke. The median (interquartile range) arm subscore of the Motricity Index at 1 wk was 77 (20.3-93). The median (interquartile range) Action Research Arm Test scores before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up were 33 (3.5-52)
and 52 (34-55.8), respectively. The optimal arm subscore of the Motricity Index to predict Action Research Arm Test score of 45 or higher before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up were 71 and 58, respectively.
Conclusions: Early arm subscore of the Motricity Index at 1 wk predicts upper limb functional capacity before inpatient rehabilitation facility discharge and at 3-mo outpatient follow-up. Measuring the effectiveness of interventions is accepted as being central to good practice. This page presents the best available information on how outcome
measures for stroke might be classified and selected for use, based upon their measurement qualities. EBRSR Review by ICF[edit | edit source] The EBRSR reviewed a selection of outcome measures put together a review that provides the best available information on how outcome measures might be classified and selected for use, based upon their
measurement qualities[1]. Body structure (impairments) Activities (limitations to activity–disability) Participation (barriers to participation--handicap) Beck Depression Inventory Behavioral Inattention Test Canadian Neurological Scale Clock Drawing Test Frenchay Aphasia Screening Test Fugl-Meyer Assessment General Health Questionnaire -28
Geriatric Depression Scale Hospital Anxiety and Depression Scale Line Bisection Test Mini Mental State Examination Modified Ashworth Scale Montreal Cognitive Assessment Motor-free Visual Perception Test National Institutes of Health Stroke Scale Orpington Prognostic Scale Stroke Rehabiliation Assessment of Movement Action Research Arm
Test Barthel Index Berg Balance Scale Box and Block Test Chedoke McMaster Stroke Assessment Scale Chedoke Arm and Hand Activity Inventory Clinical Outcome Variables Scale Functional Ambulation Categories Functional Independence Measure Frenchay Activities Index Motor Assessment Scale Nine-hole Peg Test Rankin Handicap Scale
Rivermead Mobility Scale Rivermead Motor Assessment Six Minute Walk Test Timed Up and Go Wolf Motor Function Test Canadian Occupational Performance Measure EuroQol Quality of Life Scale LIFE-H London Handicap Scale Medical Outcomes Study Short- Form 36 Nottingham Health Profile Reintegration to Normal Living Index Stroke
Adapted Sickness Impact Profile Stroke Impact Scale Stroke Specific Quality of Life See the full 141 page review US Agency for HCP&R by Problem[edit | edit source] The overview below was developed from the "Post-Stroke Rehabilitation: Assessment, Referral, and Patient Management Quick Reference Guide Number 16", published by the US
Agency for Health Care Policy and Research[2]. Type Name Approx time to administer Strengths Weaknesses Level of consciousness Glasgow Coma Scale 2 minutes Simple, valid, reliable. None observed. Stroke deficit scales NIH Stroke Scale 2 minutes Brief, reliable, can be administered by non-neurologists. Low sensitivity. Canadian Neurological
Scale 5 minutes Brief, valid, reliable. Global disability scale Rankin Scale 5 minutes Good for overall assessment of disability. Walking is the only explicit assessment criterion. Low sensitivity. Measures of disability/activities of daily living (ADL) Barthel Index 5-10 minutes Widely used for stroke. Excellent validity and reliability. Low sensitivity for
high-level functioning. Functional Independence Measure (FIM) 40 minutes Widely used for stroke. Measures mobility, ADL, cognition, functional communication. “Ceiling” and “floor” effects. Mental status screening FolsteinMini-Mental State Examination 10 minutes Widely used for screening. Several functions with summed score.
May misclassify patients with aphasia. Neurobehavioral Cognition Status Exam (NCSE) 10 minutes Predicts gain in Barthel Index scores. Unrelated to age. Does not distinguish right from left hemisphere. No reliability studies in stroke. No studies of factorial structure. Correlates with education. Assessment of motor function Fugl-Meyer 30-40
minutes Extensively evaluated measure. Good validity and reliability for assessing sensorimotor function and balance. Considered too complex and time-consuming by many. Motor Assessment Scale 15 minutes Good, brief assessment of movement and physical mobility. Reliability assessed only in stable patients.
Sensitivity not tested. Motricity Index 5 minutes Brief assessment of motor function of arm, leg, and trunk. Sensitivity not tested. Balance assessment Berg Balance Assessment 10 minutes Simple, well established with stroke patients, sensitive to change. None observed. Rivermead Mobility Index 5 minutes Valid, brief, reliable test of physical
mobility. Sensitivity not tested. Assessment of speech and language functions Boston Diagnostic & Aphasia Examination 1-4 hours Widely used, comprehensive, good standardisation data, sound theoretical rationale. Time to administer long; half of patients cannot be classified.

Porch Index of Communicative Ability (PICA) 1/2-2 hours Widely used, comprehensive, careful test development and standardisation. Time to administer long. Special training required to administer. Inadequate sampling of language other than one word and single sentences. Western Aphasia Battery 1-4 hours Widely used, comprehensive. Time to
administer long. “Aphasia quotients” and “taxonomy” of aphasia not well validated. Depression scales Beck Depression Inventory (BDI) 10 minutes Widely used, easily administered. Norms available. Good with somatic symptoms. Less useful in elderly and in patients with aphasia or neglect.High rate of false positives. Somatic items may not be due to
depression. Center for Epidemiologic Studies Depression (CES-D) < 15 minutes Brief, easily administered, useful in elderly, effective for screening in stroke population. Not appropriate for aphasic patients. Geriatric Depression Scale (GDS) 10 minutes Brief, easy to use with elderly, cognitively impaired, and those with visual or physical problems or
low motivation. High false negative rates in minor depression. Hamilton Depression Scale < 30 minutes Observer rated; frequently used in stroke patients. Multiple differing versions compromise interobserver reliability. Measures of instrumental ADL PGC Instrumental Activities of Daily Living 5-10 minutes Measures broad base of information
necessary for independent living. Has not been tested in stroke patients. Frenchay Activities Index 10-15 minutes Developed specifically for stroke patients; assesses broad array of activities. Sensitivity and interobserver reliability not tested; sensitivity probably limited. Family assessment Family Assessment Device (FAD) 30 minutes Widely used in
stroke. Computer scoring available. Excellent validity and reliability. Available in multiple languages. Assessment subjective; sensitivity not tested; “ceiling” and “floor” effects. Health status/ quality of life measures Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey 10-15 minutes Generic health status scale SF36 is improved version
of SF20. Brief, can be self – administered or administered by phone or interview. Widely used in the United States. Possible “floor” effect in seriously ill patients (especially for physical functioning), suggests it should be supplemented by an ADL scale in stroke patients. Sickness Impact Profile (SIP) 0-30 minutes Comprehensive and well-evaluated.
Broad range of items reduces “floor” or “ceiling” effects. Time to administer somewhat long. Evaluates behavior rather than subjective health; needs questions on well-being, happiness, and satisfaction. References[edit | edit source] ↑ Katherine Salter, Nerissa Campbell, Marina Richardson, Swati Mehta, Jeffrey Jutai, Laura Zettler, Matthew Moses,
Andrew McClure. Outcome Measures in Stroke Rehabilitation. EBRSR, 2013 ↑ Post-stroke rehabilitation: assessment, referral, and patient management.

U.S. Department of Health and Human Services Public Health Service. Agency for Health Care Policy and Research. Clin Pract Guidel Quick Ref Guide Clin. 1995 May;(16):i-iii, 1-32. Apply Today The Motricity Index (MI) is an ordinal method of measuring limb strength developed by Demeurisse et al in 1980.
In the original study, numerous arm and leg movements were analyzed in the first six months post stroke. One movement at the proximal, middle and distal joints from the arm and leg was selected to represent strength at each joint. Based on an analysis of early stroke recovery in the first 6 months post stroke, weighted scores were developed to
represent the difficulty of progressing from one muscle grade to the next. Maximum total arm score is 99+ (range 0-99) and the same for the leg score. Guidelines for administering the MI were developed by Collin and Wade 1990.

Upper Extremity tests: shoulder abduction, elbow flexion, pinch grip Lower Extremity tests: hip flexion, knee extension, dorsiflexion (Tests administered in the sitting position) Scoring for all movements except grip: 0 - No movement 9 - Palpable contraction in muscle, but no movement 14 - Visible movement, but not full range and not against gravity
19 - Full range of movement against gravity, but not resistance 25 - Full movement against gravity but weaker than the other side 33 - Normal power Grip scoring 0 - No movement 11 - Beginnings of prehension 19 - Able to grip cube, but not hold it against gravity examiner may need to lift the wrist) 22 - Able to grip and hold the cube against gravity
26 - Able to grip and hold the cube against a weak pull, but weaker than the other side 33 - Normal power 6 items on each side (3 for the arm; 3 for the leg) 5 minutes 5 minutes for experienced examiners working with patients who are cognitively intact Chronic Stroke: (Fayazi, Dehkord, Dadgoo, & Salehi, 2012; n = 20; age range = 37 to 76; time
post stroke range = 3 months to 4 years; male = 10; female = 10) SEM for entire group (n = 20): 4.66 Chronic Stroke: calculated using SEM from (Fayazi et al., 2012) MCID is not reported in the literature. Upper Extremity Hemiparesis: (Sunderland, Tinson, Bradley, & Hewer, 1989; n = 38; age range = 31 to 82; average age = 67; left arm affected,
n = 21; right arm affected = 17; MCA stroke, n = 36; brainstem stroke, n = 2) 1 month cut-off scores > 18 indicates a score above zero on Frenchay Arm Test at 6 months, measuring functional use of affected limb Acute/Chronic Stroke: (Demeurisse, Demol, & Robaye, 1980; n = 100; measured at 11 days, 2, 4 and 6 months post stroke; mean age
(total) = 69, 59 men, mean age = 67; 41 women, mean age = 71; left side hemiplegia = 36, right side hemiplegia = 64) *Authors do not report the normative data, but the measure and subsequent norms were developed using this population Subacute/Chronic Stroke: (Collin & Wade, 1990; n = 36; weeks post stroke = 6 (27 weeks), 12 (25 weeks); 18
(14 weeks); age range (male) = 15 to 77; mean age (male) = 56.1; age range (female) = 45-69; mean age (female) = 59.9; right side hemiplegia = 21) Observer 1 upper extremity (SD): 30 (36) Observer 2 upper extremity (SD): 31 (39) Mean Standard Deviation Observer 1 30 36 Observer 2 31 39 Acute/Subacute Stroke: (Bohannon, 1999; n = 15; age
range = 46 to 81; mean age = 66.7; within 15 days of onset; no comorbidities affecting upper extremity) Pinch-grasp mean, median, range score: 15.2; 20.5; 0-33.0 Elbow flexion mean, median, range score: 19.7; 25.0; 0-33.0 Shoulder abduction mean, median, range score: 18.7; 22.0; 0-33.0 Total motricity mean, median, range score: 54.6; 70.5; 1-
100.0 Motricity Index Subscale Mean (95% CI) Median Range Pinch-Grasp 15.2 (5.5-24.9) 20.5 0-33.0 Elbow Flexion 19.7 (10.3-29.1) 25.0 0-33.0 Shoulder Abduction 18.7 (10.6-26.8) 22.0 0-33.0 Total Motricity 54.6 (28.2-81.0) 70.5 1-100.0 Acute/Chronic Stroke: (Hsieh et al., 1998; n = 50; mean age = 65; male = 30; female = 20; median, range days
post onset = 55 (8-535); subarachnoid hemorrhage = 7; cerebral hemorrhage = 13; cerebral infarction = 21; other = 9; right-sided paresis = 22; left-sided paresis = 23; bilateral paresis = 5) Mean score for total upper extremity motricity: 46.2 (31.9) Subacute/Chronic Stroke: (Jacob-Lloyd, Dunn, Brain, & Lamb, 2005; upper extremity n = 22; age >
60 years, n = 85%(of total study n = 55); assessed average of 76 days post onset and 6 months + 76 days (average) post onset) Discharge (average 76 days post onset) median: 77 Discharge (average 76 days post onset) IQR: 77-84 6 month post discharge median: 100 6 month post discharge IQR: 77-100 Time Post Onset Median IQR Discharge (76 day
average) 77 77-84 6 months post discharge 100 77-100 Lower Extremity: Subacute/Chronic Stroke: (Collin & Wade, 1990) Observer 1 lower extremity (SD): 52 (20) Observer 2 lower extremity (SD): 55 (22) Median Standard Deviation Observer 1 52 20 Observer 2 55 22 Subacute/Chronic Stroke: (Jacob-Lloyd et al., 2005) Discharge (average 76 days
post onset) median: 76 Discharge (average 76 days post onset) IQR: 52-94 6 month post discharge median: 76 6 month post discharge IQR: 48-100 Time post onset Median IQR Discharge (76 day average) 76 52-94 6 months post discharge 76 48-100 Subacute Stroke: (Cameron & Bohannon, 1999; n = 15; age range = 29 to 77; mean age = 53.7; male
= 11; female = 4; left-sided hemiparesis = 8; right-sided hemiparesis = 7) Hip flexion mean: 20.3 Hip flexion standard deviation: 6.5 Hip flexion range: 9-33 Knee extension mean: 21.2 Knee extension standard deviation: 7.7 Knee extension range: 0-33 Ankle dorsiflexion mean: 11.7 Ankle dorsiflexion standard deviation: 10.6 Ankle dorsiflexion range:
0-33 All mean: 54.3 All standard deviation: 20.9 All range: 10-100 Motricity Index Subscale Mean Standard deviation Range Hip flexion 20.3 6.5 9-33 Knee extension 21.2 7.7 0-33 Ankle dorsiflexion 11.7 10.6 0-33 All 54.3 20.9 10-100 Chronic: (Fayazi et al., 2012) Mean score at week 1 (SD): 58.20 (17.683) Mean score at week 2 (SD): 56.60 (19.632)
Week 1 Week 2 Mean score (SD) 58.20 (17.683) 56.60 (19.632) Chronic Stroke: (Fayazi et al., 2012) Excellent test-retest reliability: (ICC = .93) Subacute/Chronic Stroke: (Collin & Wade, 1990) Excellent interrater reliability: MI arm (Spearman’s rho = .88, p < 0.001) Excellent interrater reliability: MI leg (Spearman’s rho = .87, p < 0.001) Excellent
interrater reliability: MI side (Spearman’s rho = .88, p < 0.001) Chronic Stroke: (Fayazi et al., 2012) Excellent intra-rater reliability (ICC = 0.93, 95% CI = 0.84-0.97, p < 0.001) Normative Sample: (Haley et al., 1992; n = 412) Excellent: Cronbach's alpha = .95-.99* *Scores > .9 may indicate redundancy in scale questions. Acute Stroke: (Cameron &
Bohannon, 2000; n = 15) Adequate: Cronbach α of lower extremity = .77 Upper extremity = unknown Predictive validity Subacute/Chronic Stroke: (Collin and Wade, 1990) Excellent predictive validity of MI score at 6 weeks and walking ability at 18 weeks Upper Extremity Hemiparesis: (Sunderland et al., 1989) Cut off scores on Motricity Index at 1
month were best predictor of functional outcomes at 6 months when compared with percentage grip, the Motor Club Assessment, Frenchay Arm Test, and the 9-Hole Peg Test (Sunderland et al., 1989) Subacute/Chronic Stroke: (Collin & Wade, 1980) At 6 weeks post stroke, lower scores on the MI-Leg combined with the Trunk Control Test predicted
failure to walk by 18 weeks. One Year or More Post Stroke: (Kong et al., 2011; n = 140; mean age = 61.0 (13.3); male, n = 88; UE MI mean = 21.0 (25.9); LE MI mean = 29.8 (27.2); Modified Barthel Index mean = 42.8 (26.3); Dysphasia, n = 37; Neglect, n = 32; Sensory impairment, n = 80) Only 28.3% gained upper limb dexterity post stroke Sensory
impairment, severe spasticity and low scores on MAS, UEMI and LEMI were significantly correlated to poor dexterous function Severe spasticity was correlated with low UEMI score and poor dexterity Poor dexterous function was predicted by a severe stroke, neglect, sensory impairment, total/partial anterior circulation stroke and low MBI, UEMI
and LEMI scores on rehabilitation admission The most important predictor of dexterity was the UEMI score on admission to rehabilitation The ability to do a pin grip at admission to acute rehabilitation was a predictor of recovering UE dexterity ( e.g. the probability of regaining dexterity was 3.4% in patients with absent pinch group but 80% in those
with MI scores of 22 or higher) Factors correlating MI scores to Upper Limb Dexterity Variable Upper Limb Dexterity Yes No P Value Upper Extremity MI score (Rehab) Lower Extremity MI score (Rehab) 48.7 (20.7) 11.2 (19.1) 55.0 (17.6) 19.8 (23.7) <0.001 <0.001 Stroke: (Bland et al., 2012; two samples of patients in an inpatient rehabilitation
facility unit (n = 110 and 159; mean age 62 (14) and 63 (15), respectively) Admission Lower extremity MI was 65 (26) and 59 (30), respectively in patients subacute post stroke Adequate correlation between Lower Extremity MI at admission and speed of 10-meter walk speed at discharge (r = 0.47) The lower extremity MI did not explain a significant
amount of the variance in walking speed at discharge nor differentiate household versus community. Ischemic or Hemorrhagic Stroke: (Aufman et al., 2013; n = 198; mean age of nondrivers = 64.1 (± 14.0); mean age of nonreturners = 59.9 (±13); mean age of returners = 61.5 (± 13.7)) LEMI and FIM-C explained 30% of the variance in patients who
returned to driving at six months post-stroke. Acute Stroke: (Cameron & Bohannon, 2000) Excellent predictive validity of dynamometer measurements and MI arm scores (r = 0.78) Excellent predictive validity of dynamometer measurements and MI leg scores (r = 0.91) Concurrent validity Stroke: (Arwert et al, 2016; n = 51; average time since stroke
= 8 months (3-27 months); female, n = 16) Excellent concurrent validity between the MHQ and the Arm MI for all patients (r = 0.78) Average concurrent validity between the MHQ and the Arm MI for patients with less than 100 on the Arm MI (r = 0.65) Average to Excellent concurrent validity between Arm MI and functional subscales of the MHQ
Subscales of the MHQ MI correlation Overall Hand Function 0.80 ADL 0.67 Pain 0.43 Work Performance 0.59 Aesthetics 0.67 Satisfaction 0.72 MHQ Total 0.78 Upper Extremity: (Sunderland et al., 1989) When comparing the 9 Hole Peg Test, Motor Club Impairment, Frenchay Arm Test and MI Arm Score, the MI Arm test was the most sensitive
measure in detecting early change Stroke: (Bohannon, 1999) Excellent concurrent validity between dynamometry measurements of the upper extremity and the MI Arm Score (r = 0.89; p<0.001) Acute Stroke: (Cameron & Bohannon , 2000), (Bohannon, 1999), (Sunderland et al., 1989) Excellent concurrent validity between dynamometry
measurements and Leg MI Hip Flexion (r = .85) Knee Extension (r = .83) Ankle Dorsiflexion (r = .89) All (r = .78) Excellent concurrent validity between dynamometry measurements and Arm MI MI Pinch Grasp and Dynamometry Hand Grasp (r = .81) Elbow Flexion (r = .87) Shoulder Abduction (r = .80) All (r = 0.91) Subacute/Chronic Stroke: (Collin
& Wade, 1990) Excellent concurrent validity between the Rivermead Motor Assessment and the MI Time RMA/MI-arm RMA/MI-leg 6 weeks 0.76* 0.81* 12 weeks 0.73* 0.81* 18 weeks 0.74** 0.75** * p < 0.001; ** p < 0.01 Post Stroke Hemiplegia: (Lu et al., 2015; n = 22; mean age = 54.8 (8.5); male, n = 18; able to walk independently; mean Leg MI
score = 70.4 (21.5); Chinese sample) Adequate concurrent validity of the Wisconsin Gait Scale (WGS) with the MI (r = -0.687; p < 0.01) Excellent concurrent validity of the Gait Abnormality Rating Scale (GARS) with the MI (r = -0.742; p < 0.01) Within 6 Months Post Stroke: (Meyer et al., 2015; n = 122; males, n = 77; mean post stroke time = 82
days; average age = 67 (58.8-76.1; Belgian sample) Upper limb somatosensory impairments were common, with prevalence rates 21%- 54% Poor to Adequate concurrent validity between somatosensory deficits and MI scores for the UE (r = -0.56 to 0.35) Poor to Adequate concurrent validity between somatosensory and motor deficits (r = 0.22-0.61)
There were consistently stronger correlations between motor and somatosensory deficits in patients with visuospatial neglect ( r = 0.44-0.78) compared to patients without neglect (r = 0.08-0.59) The MI median (interquartile range) was 67.5 for patients overall and 23 (0-83) for those with Neglect and 76 for patients without neglect (p < 0.02)
Somatosensation Association with MI Exteroceptive Em-NSA light touch Em-NSA pressure Em NSA pinprick PTT light touch Proprioceptive Em-NSA movement sense TFT position sense Higher Cortical Em-NSA sharp/dull NSA stereognosis Two point discrimination 0.318 0.337 0.348 -0.564 0.394 -0.354 0.220 0.535 -0.316 Em-NSA = Erasmus MC
modification of the revised Nottingham Sensory Assessment; TFT = Thumb Finding Test; Statistically significant adequate correlations Ischemic or Hemmorhagic Stroke: (Bertrand et al., 2015; n = 34) Participants were recruited from an acute neurology ward after their first stroke, and were administered the MI Arm, Chedoke Arm and Hand Activity
Inventory (CAHAI), and the ABILHAND questionnaire. Excellent concurrent validity between the MI Arm and the CAHAI at weeks 2, 4, 8, and 12 (r = 0.87-0.94) Excellent concurrent validity between the MI Arm at weeks 1, 2, 4, 8, and 12 and the ABILHAND at week 12 (r = 0.69-0.82) Subacute/Chronic Stroke: (Collin & Wade ,1990) Excellent
convergent validity of the MI arm score and the MI leg score with the Rivermead Motor Assessment Weeks Post Stroke RMA Arm vs MI Arm RMA Leg vs MI Leg 6 (n = 27) 0.76** 0.81** 12 (n = 25) 0.73** 0.81** 18 (n = 14) 0.74* 0.75* **p < 0.001; *p < 0.01; RMA = Rivermead Motor Assessment; MI = Motricity Index When the Motricity Index was
initially developed, Demeurisse et al. (1980, p.

388) applied a Hotelling’s analysis and determined that, “because of the nearness of these coefficients, the sum of the values of the six items in question is a good measurement of analytical motricity.” Content validity was not discussed in the literature.

The Motricity Index, however, is often used when examining validity, reliability and responsiveness of other rehab measures (Wade, 1988; Benaim et al., 1999; Bertrand et al., 2015) Upper Extremity: Adequate ceiling effects: 100% of participants scored above midpoint; 18% gained maximum score (Jacob-Lloyd et al., 2005) A comparison of grip
strength among the Frenchay Arm Test, the Motor Club, the 9-Hole Peg Test and the MI revealed floor effects on admission for the Frenchay and Peg Test, yet the MI demonstrated 57% of patients had measurable pinch grip within first 3 weeks of stroke; only 2% had normal pinch grip (Sunderland et al., 1989). When all patients were examined 0%
showed a floor effect and 28% showed a ceiling effect with respect to the MI Arm. In the subgroup with MI Arm score <100, 0% of patients had a floor or ceiling effect (Arwert et al., 2016) Lower Extremity: Poor ceiling effects: 76% of participants scored at or above midpoint; 24% gained maximum score (Jacob-Lloyd et al., 2005) Upper Extremity:
Large responsiveness (ES = 0.91, Z = 5.45, p < 0.001) to detecting changes < 3 months after stroke. Measurements were done within the first 72h of admission and on the last day of hospital stay (Safaz et al., 2009). Increase observed for MI tests administered 6 weeks apart, but no statistical measure noted (Collin & Wade, 1990) Moderate
sensitivity to detecting change < 3 months after stroke (Effect Size = .70) (Sunderland et al., 1989; n = 31; assessed at initial-1 month; 1-3 months) Small sensitivity to detecting change > 3 months after stroke (Effect size = .29) (Sunderland et al., 1989; n = 31; assessed at 3-6 months) Lower Extremity: Small sensitivity to detecting change in the
acute phase. Mean number of days between tests = 9.6 days (effect size = .30; SRM = 1.0) (Vos-Vromans et al., 2005). Arwert HJ, Keizer S, Kromme CH, Vliet Vlieland TP, Meesters JJ. (2016) Validity of the Michigan Hand Outcomes Questionnaire in Patients With Stroke. Archives of physical medicine and rehabilitation. 97(2):238-44. Find it on
PubMed. Aufman, EL, Bland, MD, Barco, PP, Carr, DB, Lang CE. (2013) Predictors of return to driving after stroke. Am J Phys Med Rehabil 92(3): 1-8. Find it on PubMed. Bertrand AM, Fournier K, Wick Brasey MG, Kaiser ML, Frischknecht R, Diserens K. (2015) Reliability of maximal grip strength measurements and grip strength recovery following a
stroke. JHT 28(4):356-62. Find it on PubMed. Bland MD, Sturmoski A, Whitson M, Connor LT, Fucetola R, Huskey T, et al. (2012) Prediction of discharge walking ability from initial assessment in a stroke inpatient rehabilitation facility population. Archives of physical medicine and rehabilitation. 93(8):1441-7. Find it on PubMed.
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