Deans' stroke musings: The Adult Assisting Hand Assessment Stroke: Psychometric properties of an observation-based bimanual upper-limb performance measurement

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Thursday, October 23, 2025

The Adult Assisting Hand Assessment Stroke: Psychometric properties of an observation-based bimanual upper-limb performance measurement

Assessments DO NOTHING unless you map EXACT RECOVERY PROTOCOLS TO THEM! This was absolutely useless, NOTHING ON PROTOCOLS THAT WILL DELIVER RECOVERY!

Inter-rater reliability does nothing for survivor recovery!

The Adult Assisting Hand Assessment Stroke: Psychometric properties of an observation-based bimanual upper-limb performance measurement

Objective: To investigate interrater and intrarater reliability, measurement error and convergent and discriminative validity of the Adult Assisting Hand Assessment Stroke (Ad-AHA Stroke).

Design: Cross-sectional observational study

Setting: Seven stroke rehabilitation centers

Participants: A total of 118 stroke survivors (reliability sample: n=30; validity sample: n=118) were included (median age 67 years (interquartile range (IQR) 59-76); median time post stroke 81 days (IQR 57-117).

Interventions: N/A.

Main Outcome Measures: Ad-AHA Stroke, Action Research Arm Test (ARAT), Upper Extremity Fugl-Meyer assessment (UE-FMA). The Ad-AHA Stroke is an observation-based instrument assessing the effectiveness of the spontaneous use of the affected hand when performing bimanual activities in adults after stroke. Reliability of Ad-AHA stroke was examined using intraclass correlation coefficients (ICC), Bland-Altman plots, and weighted kappa (Kw) statistics for reliability on item level. Standard error of measurement (SEM) was calculated based on Ad-AHA units. Convergent validity was assessed by calculating Spearman rank correlation coefficients between Ad-AHA stroke and ARAT and UE-FMA. Comparison of Ad-AHA stroke scores between subgroups of patients according to hand dominance, neglect and age evaluated discriminative validity.

Results: Intrarater and interrater agreement showed an ICC of 0.99 (95% CI=0.99-0.99), a SEM of 2.15 and 1.64 out of 100, respectively and Kw for item scores were all above 0.79. The relation between Ad-AHA and other clinical assessments was strong (rs=0.9). Patients with neglect had significantly lower Ad-AHA scores compared to patients without neglect (p=0.004).

Conclusion: The Ad-AHA Stroke captures actual bimanual performance. Thereby it provides an additional aspect of upper limb assessment with good to excellent reliability and low SEM for patients with sub-acute stroke. High convergent validity with ARAT and UE-FMA and discriminative validity was demonstrated.