To develop and validate a quick observational clinical tool, the Functional ASsessment Test for Upper Limb (FAST-UL), for the evaluation of upper limb impairment in goal-directed functional-oriented motor tasks after stroke.
Observational, cross-sectional, psychometric study.
Inpatient and outpatient rehabilitation clinic.
A total of 188 post-stroke survivors (mean age 65.2±17.7 years, 61% men, 48% with ischemic stroke and 66% in the sub-acute phase; N=188).
Main Outcome Measures
Principal component analysis and Rasch analysis through a Partial Credit Model were used to assess the structure and psychometric properties of the 5 items of the FAST-UL (Hand to Mouth [HtM], Reach to Target, Prono-Supination, Grasp and Release, and Pinch and Release [PaR]).
The Cronbach's α equal to 0.96 was indicative of an acceptable internal consistency; the reliability, as measured through the Person Separation Reliability equal to 0.87, was good. The FAST-UL tool was unidimensional. All the FAST-UL items were found to fit well the Rasch measurement model. The easiest to perform FAST-UL item was the HtM movement while the most difficult was the PaR movement.
The FAST-UL is a quick, easy-to-administer observational assessment tool of upper limb motor impairment in post-stroke survivors with good item-level psychometric properties.
List of abbreviations:FAST-UL (Functional Assessment Test for Upper Limb), GaR (Grasp and Release), HtM (Hand to Mouth), ICF (International Classification of Functioning), MnSq (mean square standardized residuals), PaR (Pinch and Release), PS (Prono-supination), RtT (Reach to Target), UL (upper limb)
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Archives of Physical Medicine and Rehabilitation
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Stroke rehabilitation.Lancet. 2011; 377: 1693-1702
- Do activity level outcome measures commonly used in neurological practice assess upper-limb movement quality?.Neurorehabil Neural Repair. 2017; 31: 623-637
- Kinematic analysis of the upper extremity after stroke—how far have we reached and what have we grasped?.Phys Ther Rev. 2015; 20: 137-155
- The effect of time spent in rehabilitation on activity limitation and impairment after stroke.Cochrane database Syst Rev. 2021; 10CD012612
- Use of The International Classification of Functioning, Disability and Health (ICF) as a conceptual framework and common language for disability statistics and health information systems.BMC Public Health. 2011; 11: S3
- Assessment of upper extremity impairment, function, and activity after stroke: foundations for clinical decision making.J Hand Ther. 2013; 26: 104-115
- Scales to assess gross motor function in stroke patients: a systematic review.Arch Phys Med Rehabil. 2014; 95: 1174-1183
- Relationship between clinical measures of upper limb movement quality and activity poststroke.Neurorehabil Neural Repair. 2019; 33: 432-441
- Characterization of stroke-related upper limb motor impairments across various upper limb activities by use of kinematic core set measures.J Neuroeng Rehabil. 2022; 19: 2
- Reducing the number of test items of the Action Research Arm Test post stroke: a decision tree analysis.Arch Phys Med Rehabil. 2022; 103: 1582-1591
- Accuracy of observational kinematic assessment of upper-limb movements.Phys Ther. 1998; 78: 259-270
- Systematic review on kinematic assessments of upper limb movements after stroke.Stroke. 2019; 50: 718-727
- Development and validation of a scale for rating motor compensations used for reaching in patients with hemiparesis: the reaching performance scale.Phys Ther. 2004; 84: 8-22
- Reaching performance scale for stroke—test-retest reliability, measurement error, concurrent and discriminant validity.PM R. 2022; 14: 337-347
- Measurement properties of the reaching performance scale for stroke.Disabil Rehabil. 2021; 43: 1171-1175
- Validity of robot-based assessments of upper extremity function.Arch Phys Med Rehabil. 2017; 98 (e2): 1969-1976
- A large calibrated database of hand movements and grasps kinematics.Sci Data. 2020; 7: 12
- Technology-aided assessments of sensorimotor function: current use, barriers and future directions in the view of different stakeholders.J Neuroeng Rehabil. 2019; 16: 1-17
- Normative data for an instrumental assessment of the upper-limb functionality.Biomed Res Int. 2015; 2015484131
- Using kinematic analysis to evaluate constraint-induced movement therapy in chronic stroke patients.Neurorehabil Neural Repair. 2008; 22: 31-39
- Effects of a robot-assisted training of grasp and pronation/supination in chronic stroke: a pilot study.J Neuroeng Rehabil. 2011; 8: 63
- Classification of posture in poststroke upper limb spasticity: a potential decision tool for botulinum toxin A treatment?.Int J Rehabil Res. 2012; 35: 227-233
- A quantitative taxonomy of human hand grasps.J Neuroeng Rehabil. 2019; 16: 28
- Kinematic synergies of hand grasps: a comprehensive study on a large publicly available dataset.J Neuroeng Rehabil. 2019; 16: 63
- A systematic analysis of hand movement functionality: qualitative classification and quantitative investigation of hand grasp behavior.Front Neurorobot. 2021; 15: 1-14
- The impact of shoulder abduction loading on volitional hand opening and grasping in chronic hemiparetic stroke.Neurorehabil Neural Repair. 2017; 31: 521-529
Patrick A, et al. eRm: Extended Rasch. 2021.
- Measuring behaviours and perceptions: Rasch analysis as a tool for rehabilitation research.J Rehabil Med. 2003; 35: 105-115
- Cronbach's alpha.BMJ. 1997; 314: 572
- An index of person separation in latent trait theory, the traditional KR20 index, and the Guttman scale response pattern.Educ Res Perspect. 1982; 9: 95-104
- Critical values for Yen's Q(3): identification of local dependence in the Rasch model using residual correlations.Appl Psychol Meas. 2017; 41: 178-194
- Formalizing dimension and response violations of local independence in the unidimensional Rasch model.J Appl Meas. 2008; 9: 200-215
- Rasch analysis staging methodology to classify upper extremity movement impairment after stroke.Arch Phys Med Rehabil. 2013; 94: 1527-1533
- Physical rehabilitation approaches for the recovery of function and mobility following stroke.Cochrane Database Syst Rev. 2014; 2014CD001920
- Pushing the rehabilitation boundaries: hand motor impairment can be reduced in chronic stroke.Neurorehabil Neural Repair. 2020; 34: 733-745
- Item difficulty of Fugl-Meyer assessment for upper extremity in persons with chronic stroke with moderate-to-severe upper limb impairment.Front Neurol. 2020; 11577855
- Recovery of grasp versus reach in people with hemiparesis poststroke.Neurorehabil Neural Repair. 2006; 20: 444-454
- A taxonomy of functional upper extremity motion.Front Neurol. 2019; 10: 857
- Measures of interjoint coordination post-stroke across different upper limb movement tasks.Front Bioeng Biotechnol. 2020; 8620805
- The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance.Scand J Rehabil Med. 1975; 7: 13-31
- Investigation of a new motor assessment scale for stroke patients.Phys Ther. 1985; 65: 175-180
- The Stroke Rehabilitation Assessment of Movement (STREAM): a comparison with other measures used to evaluate effects of stroke and rehabilitation.Phys Ther. 2003; 83: 617-630
- Motor evaluation in vascular hemiplegia.Eur Neurol. 1980; 19: 382-389
- Upper limb outcome measures used in stroke rehabilitation studies: a systematic literature review.PLoS One. 2016; 11: 1-16
- Technology-aided assessment of functionally relevant sensorimotor impairments in arm and hand of post-stroke individuals.J Neuroeng Rehabil. 2020; 17: 128
- Can quality of movement be measured? Rasch analysis and inter-rater reliability of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES).Clin Rehabil. 2006; 20: 871-884
- The Fugl-Meyer upper extremity scale.J Physiother. 2017; 63: 53
Published online: November 01, 2022
Accepted: October 11, 2022
Received in revised form: August 11, 2022
Received: March 15, 2022
Publication stageIn Press Journal Pre-Proof
© 2022 by the American Congress of Rehabilitation Medicine.