Deans' stroke musings: Development and initial psychometric evaluation of the Stroke Arm Ladder - a measure of upper extremity function post stroke

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.

Monday, September 8, 2025

Development and initial psychometric evaluation of the Stroke Arm Ladder - a measure of upper extremity function post stroke

'Measurements' DO NOTHING TO GET SURVIVORS RECOVERED! You need EXACT REHAB PROTOCOLS for that! When will you accomplish that? NEVER? Does anyone in stroke have two functioning neurons to rub together for a spark of intelligence?

Development and initial psychometric evaluation of the Stroke Arm Ladder - a measure of upper extremity function post stroke

Johanne Higgins, Lois E. Finch, Nancy E, Mayo +1, View all authors and affiliations

Volume 25, Issue 8

https://doi.org/10.1177/0269215510389496

Objective:

To develop an adaptive measure, the Stroke Arm Ladder, to parsimoniously quantify upper extremity function post stroke.

Setting:

Various studies conducted in Montreal and elsewhere in Canada. Subjects: A total of 4058 persons with stroke who participated in various studies were assessed on different occasions post stroke. Assessments spanned from 3 days to 1 year post stroke.

Main measures:

A calibrated bank containing 49 items from tests and indices designed to assess global motor recovery of the upper extremity, upper extremity function and activities involving the upper extremity was used. Data including all testing occasions were analysed to test whether they adhered to the expectations of the Rasch partial credit model and whether item hierarchy remained stable across testing occasions.

Results:

Fifteen items did not meet the requirements of the Rasch model and were deleted. An adaptive measure of upper extremity function, the Stroke Arm Ladder, containing 34 items was created. The easiest item was partially executing the bilateral task of tying a scarf around one’s neck, while the hardest item was being able to transfer more than 60 blocks on the Box and Block Test. The items’ difficulty thresholds cover a wide range of difficulty levels from −7.4 to 6.2 and the global fit statistics (χ2: 331; probability: 0.18), confirmed content validity.

Conclusion:

The Stroke Arm Ladder demonstrates adequate initial psychometric properties. Further testing of the measure in its adaptive format is necessary before it can be used clinically.