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Comparing 2 Versions of the Chedoke Arm and Hand Activity Inventory With the Action Research Arm Test

SR Barreca, MScPT(Dip), is Assistant Clinical Professor, McMaster University, Hamilton, Ontario, Canada, and Research Clinician, Orthopedic and Rehabilitation Services, Hamilton Health Sciences, Hamilton, Ontario, Canada
PW Stratford, MScPT, is Professor, School of Rehabilitation Science, and Associate Member, Department of Clinical Epidemiology and Biostatistics, McMaster University
LM Masters, MScOT, is Research Therapist, Orthopedic and Rehabilitation Services, Hamilton Health Sciences
CL Lambert, BScPT, is Physical Therapist, Orthopedic and Rehabilitation Services, Hamilton Health Sciences
J Griffiths, BScPT, is Physical Therapist, Orthopedic and Rehabilitation Services, Hamilton Health Sciences

(barreca{at}hhsc.ca) Address all correspondence to Ms Barreca at Hamilton Health Sciences, Box 2000, Station A, Holbrook 1, Chedoke Site, Hamilton, Ontario, Canada L8M 3Z5

Background and Purpose. The Chedoke Arm and Hand Activity Inventory (CAHAI) is a new, validated upper-limb measure that uses a 7-point quantitative scale in order to assess functional recovery of the arm and hand after a stroke. The purposes of this study were: (1) to determine whether the longitudinal validity of scores on 2 versions of a new upper-limb measure, the CAHAI (CAHAI-9 and CAHAI-13), was greater than that of scores on the Action Research Arm Test (ARAT) and (2) to determine whether the cross-sectional and longitudinal validity of the CAHAI-13 scores was greater than that of the CAHAI-9 scores.

Subjects. One hundred five people with upper-limb dysfunction following a stroke were stratified into 2 impairment groups (mild to moderate and severe), which were expected to change by different amounts.

Methods. The CAHAI-13 and ARAT were administered twice (time between assessments varied from 2 to 6 weeks). Receiver operating characteristic curves, Pearson product moment coefficient of correlation, and regression analyses were used.

Results. Receiver operating characteristic curve areas (CAHAI-13=0.86, CAHAI-9=0.82, ARAT=0.72) were significantly greater for the CAHAI versions. Scores on both CAHAI versions had identical levels of cross-sectional validity.

Discussion and Conclusion. Both CAHAI versions demonstrated more sensitivity to change than the ARAT. It remains unclear whether the CAHAI-9 provides precise estimates of CAHAI-13 scores at the individual level. [Barreca SR, Stratford PW, Masters LM, et al. Comparing 2 versions of the Chedoke Arm and Hand Activity Inventory with the Action Research Arm Test. Phys Ther. 2006;86:245–253.]

Key Words: Arm • Cerebrovascular accident • Hand • Outcome assessment • Recovery of function