Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke

Abstract

Objectives: To estimate the test-retest reliability and validity of the Chedoke Arm and Hand Activity Inventory (CAHAI) and to test whether the CAHAI was more sensitive to change in upper-limb function than the Impairment Inventory of the Chedoke-McMaster Stroke Assessment (CMSA) and the Action Research Arm Test (ARAT).

Design: Construct validation process.

Setting: Inpatient/outpatient rehabilitation facilities.

Participants: Stratified sample of 39 survivors of stroke: 24 early (mean age, 71.4 y; mean days poststroke, 27.3) and 15 chronic (mean age, 64.0 y; mean days poststroke, 101.7).

Intervention: Regular therapy.

Main outcome measures: Intraclass correlation coefficients (ICCs), receiver operating characteristic (ROC), standard error of measurement, and correlation coefficients.

Results: High interrater reliability was established with an ICC of .98 (95% confidence interval [CI], .96-.99). The minimal detectable change score was 6.3 CAHAI points. Higher correlations were obtained between the CAHAI and the ARAT and CMSA scores compared with the CMSA shoulder pain scores (1-sided, P=.001). Areas under the ROC curves were as follows: CAHAI, .95 (95% CI, 0.87-1.00); CMSA, .76 (95% CI, .61-.92); and ARAT, .88 (95% CI, 0.76-1.00).

Conclusions: High interrater reliability and convergent and discriminant cross-sectional validity were established for the CAHAI. The CAHAI is more sensitive to clinically important change than the ARAT.