http://nnr.sagepub.com/content/27/3/240.abstract?etoc
Abstract
Background and purpose. Augmenting changes
in recovery is core to the rehabilitation process following a stroke.
Hence it is essential that outcome
measures are able to detect change as it occurs, a
property known as responsiveness. This article critically reviewed the
responsiveness of functional outcome measures
following stroke, specifically examining tools that captured
upper-extremity
(UE) functional recovery. Methods. A systematic search of the literature was undertaken to identify articles providing responsiveness data for 3 types of change
(observed, detectable, and important). Results.
Data from 68 articles for 14 UE functional outcome measures were
retrieved. Larger percentage changes were required to be
considered important when obtained through
anchor-based methods (eg, based on patient opinion or comparative
measure) compared
with distribution methods (eg, statistical
estimates). Larger percentage changes were required to surpass the
measurement
error for patient-perceived functional measures
(eg, Motor Activity Log) compared with laboratory-based performance
measures
(eg, Action Research Arm Test). The majority of
rehabilitation interventions have similar effect sizes on
patient-perceived
UE function and laboratory-based UE function. Conclusions.
The magnitude of important change or change that surpasses measurement
error can vary substantially depending on the method
of calculation. Rehabilitation treatments can
affect patient perceptions of functional change as effectively as
laboratory-based
functional measures; however, larger sample sizes
may be required to account for the larger measurement error associated
with
patient-perceived functional measures.
Arm Research Action Test (ARAT) = moving stones, marbles, balls, blocks, and tubes and placing the hand on top of head, behind head. Only two functional tasks = placing a washer on a bolt and pouring water into a glass. They have a very loose definition of what functional means.
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