Abstract
Objective
To investigate the measurement properties of the Functional Test of the Hemiparetic
Upper Extremity (FTHUE) and examine how its score may or may not inform design of
a rehabilitation program.
Design
The FTHUE was recently used in the Interdisciplinary Comprehensive Arm Rehabilitation
Evaluation randomized controlled trial. This circumstance provided the opportunity
to examine the psychometric properties of the FTHUE as it pertains to contemporary
poststroke rehabilitation and recovery models.
Setting
Outpatient rehabilitation clinic.
Participants
Participants (N=109; mean age, 61.2±13.5y; mean days poststroke, 46±20.3) with resultant
hemiparesis in the upper extremity.
Interventions
Not applicable.
Main Outcome Measures
Dimensionality was examined with confirmatory factor analysis (CFA), and person and
item measures were derived with Rasch item response analysis. Therapists' notes were
also reviewed.
Results
The CFA results support unidimensionality, and 16 of 17 items fit the Rasch model.
The Rasch person separation (2.17) and item separation (4.50) indices, ability strata
(3.22), person reliability (.82), and item reliability (.95) indicate good measurement
properties. Item difficulties ranked from −6.46 to 3.43 logits; however, there was
a substantial ceiling effect of person measures. Post hoc examination of therapists'
written observations indicated that the scoring criteria are not sensitive to the
movement strategy used for task completion.
Conclusions
The FTHUE's item difficulty hierarchy indicated that scores adequately distinguished
the ability to perform simple versus complex motor movements of functional tasks.
However, the FTHUE scoring method did not allow inclusion of the type of movement
strategy used to accomplish task items. Therefore, we suggest modifications to the
FTHUE that would allow it to be used for collaborative treatment planning and align
well with more contemporary perspectives on treatment theory.
Keywords
List of abbreviations:
ASAP (Accelerated Skill Acquisition Program), CFA (confirmatory factor analysis), FTHUE (Functional Test of the Hemiparetic Upper Extremity), ICARE (Interdisciplinary Comprehensive Arm Rehabilitation Evaluation), MnSq (mean square), UEFM (upper extremity Fugl-Meyer)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 20, 2017
Footnotes
Supported by the National Institutes of Health, the National Institute of Neurological Disorders and Stroke (primary), and the National Center for Medical Rehabilitation Research of the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant no. U01NS056256). Winstein, grant PI, and Wolf grant co-PI.
Clinical Trial Registration No.: NCT00871715.
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
