Deans' stroke musings: The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation

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, January 9, 2025

The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation

'Assessments' are useless unless they are used to point to EXACT 100% RECOVERY PROTOCOLS! Since this didn't do that, I'd have EVERYONE FIRED!

The Bimanual Observation of The Hands (BOTH): Development, reliability, and validity for stroke rehabilitation

Debbie Rand,
Nitsan Omer,
Amihai Levkoviz,
Samar Assadi Khalil

Published: January 7, 2025
https://doi.org/10.1371/journal.pone.0316356

Abstract

Importance

To efficiently perform bimanual daily tasks, bimanual coordination is needed(Hell, I've not done anything bimaual in the past 18 years and I'm functioning quite well! All because my stroke medical 'professionals' completely failed at curing my spasticity, thus never getting to 100% recovery!). Bimanual coordination is the interaction between an individual’s hands, which may be impaired post-stroke, however clinical and functional assessments are lacking and research is limited.

Objectives

To develop a valid and reliable observation tool to assess bimanual coordination of individuals post-stroke.

Design

A cross-sectional study.

Setting

Rehabilitation settings.

Participants

Occupational therapists (OTs) with stroke rehabilitation experience and individuals post stroke.

Outcomes and measures

The development and content validity of BOTH included a literature review, review of existing tools and followed a 10-step process. The conceptual and operational definitions of bimanual coordination were defined as well as scoring criteria. Then multiple rounds of feedback from expert OTs were performed. OTs reviewed BOTH using the ‘Template for assessing content validity through expert judgement’ questionnaire. Then, BOTH was administered to 51 participants post-stroke. Cronbach’s alpha was used to verify internal reliability of BOTH and construct validity of BOTH was assessed by correlating it to the bimanual subtests of The Purdue Pegboard Test.

Results

Expert validity was established in two-rounds with 11 OTs. Cronbach’s alpha was α = 0.923 for the asymmetrical items, 0.897 for the symmetrical items and 0.949 for all eight items. The item-total correlations of BOTH were also strong and significant. The total score of BOTH was strongly significantly correlated with The Purdue–Both hands placement (r = .787, p < .001) and Assembly (r = .730, p < .001) subtests.

Conclusions and relevance

BOTH is a new observation tool to assess bimanual coordination post-stroke. Expert validity of BOTH was established, excellent internal reliability and construct validity were demonstrated. Further research is needed, so in the future, BOTH can be used for clinical and research purposes to address bimanual coordination post-stroke.