Action research arm test as a tool for assessment of motor recovery in patients with stroke: a critical review

Assessments that don't lead to EXACT RECOVERY PROTOCOLS are COMPLETELY FUCKING USELESS!

 Action research arm test as a tool for assessment of motor recovery in patients with stroke: a critical review

Sukanya Parag Dandekar*, Suvarna Ganvir INTRODUCTION Action Research Arm Test is considered by many in the field of stroke rehabilitation to be one of the most comprehensive quantitative measures of motor impairment following stroke, and its use has been recommended for clinical trials of stroke rehabilitation. One of the common deficits after stroke is upper and lower extremity motor impairment. The upper extremity is used principally for reaching, grasping and manipulation, sometimes for lifting the body mass, during periods of postural instability for preserving balance. Effective functional use of upper limb is absolutely dependent on functional grasp and release. Thus, the proper evaluation upper extremity after stroke is important. ARAT has also been used for evaluating upper extremity impairment in Parkinson’s disease, multiple sclerosis. The most effective use of ARAT is seen in stroke. 1,2 In this article, we review the development of this scale and its measurement properties, reliability, validity, and responsiveness. Limitations of the scale are discussed, and recommendations for future use are presented. DESCRIPTION OF THE SCALE The test consists of 19 items grouped I subtests (grasp, grip, pinch, and gross arm movement) and performance of each item is rated on a 4-point scale ranging from 0 (no movement possible) to 3 (movement performed normally). If subjects score the maximum on the first, most difficult item of each subtest, they are credited with Department of Neurosciences, D. V. V. P. F’s College of Physiotherapy, Ahmednagar, Mahrashtra, India Received: 14 June 2019 Revised: 28 June 2019 Accepted: 12 July 2019 *Correspondence: Dr. Sukanya Parag Dandekar, E-mail: sukanya.dandekar@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. 

ABSTRACT 

Action research arm test has been used widely clinically for the assessment of upper extremity function post stroke and in various other conditions. Measurement of recovery after stroke is becoming increasingly important(Then you don't know one fucking thing about getting survivors recovered! Measurements don't deliver recovery you blithering idiots!) with the advent of new treatment options under investigation in stroke rehabilitation research. The Action Research Arm Test scale was developed as the first quantitative evaluative instrument for measuring motor stroke recovery, based on a upper extremity test by Lyle. It is a well-designed, feasible and efficient clinical examination method that has been tested widely in the stroke population. Excellent interrater and intrarater reliability and construct validity have been demonstrated. Limitations of the motor domain include a ceiling effect. Further study should test performance of this scale in specific subgroups of stroke patients and better define its criterion validity, sensitivity to change, and minimal clinically important difference. Based on the available evidence, the Action Research Arm Test is recommended highly as a clinical and research tool for evaluating changes in motor impairment following stroke.