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Evaluation of Inter-Rater Reliability to Measure Hand and Arm Function in Reaching Performance Scale for Stroke Patients


Affiliations
1 Maharashtra Institute of Physiotherapy, Latur, India
2 MAEER's Physiotherapy College, Talegaon, Pune, India
3 Santosh College of Physiotherapy, Ghaziabad, India
     

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Objective: This study is to assess the inter-rater reliability of Reaching Performance Scale test in hand function evaluation.

Introduction: Stroke is defined as a rapidly developing clinical sign of focal or global disturbance of cerebral function lasting for more than 24 hours or leading to death due to no other reason than vascular origin. As there is high incidence of middle cerebral artery stroke, upper limb is more affected than the lower extremity and about 20% of the individual fail to regain any functional use of affected upper extremity. When a stroke patient attempts to move and encounters all the deficits the natural reaction is to compensate with available motor strategies. The measurement of the performance of the affected arm and hand of the patient with hemiplegia is important for determining the goal of intervention as well as outcomes of rehabilitation. So there is a need to have a scale that measures the quality of motor performances specific to the task and identify which elements of the task are missing and how they are compensated. Reaching performance scale is for the identification and quantification of movement pattern and their compensation during reach to grasp task in patients with upper extremity involvement after a stroke.

Materials & Methodology: 30 Hemiplegic patients between age group of 40-60 years who met the inclusion criteria were selected and explained about the study and procedure, and the consent for the study was taken. The Type of study is Inter-rater reliability study (correlation). The Materials used were card board cone, Table, inch tape and a chair.

Procedure: The patients were examined by two Physiotherapists respectively. The patient was seated in a chair with backrest but no arm rest. Reaching performance scale evaluated six components. For all patients both close target [Task I] and Far target [Task II] were assessed and graded. Only reach to grasp component of task are taken into account. The inter-rater reliability to measure the hand and arm function in Reaching Performance scale was statistically analysed by the Mann-Whitney test with P

Result & Conclusion: In this study the reliability between the investigators is very highly significant correlation of closed target (0.951) and P <0.05, Far target (0.946) and P<0.05. So we can conclude that inter rater reliability of RPS scale in assessing arm and hand function is high and hence RPS can also be used to assess the compensatory strategies in stroke patients for an effective intervention.


Keywords

CVA, Stroke, Arm and hand function, Reaching Performance scale, Inter-rater Reliability, Compensatory strategies
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  • Evaluation of Inter-Rater Reliability to Measure Hand and Arm Function in Reaching Performance Scale for Stroke Patients

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Authors

T. SureshKumar
Maharashtra Institute of Physiotherapy, Latur, India
A. S. Leo Rathinaraj
Maharashtra Institute of Physiotherapy, Latur, India
A. Jeganathan
MAEER's Physiotherapy College, Talegaon, Pune, India
Vigneshwaran Vellaichamy
Santosh College of Physiotherapy, Ghaziabad, India

Abstract


Objective: This study is to assess the inter-rater reliability of Reaching Performance Scale test in hand function evaluation.

Introduction: Stroke is defined as a rapidly developing clinical sign of focal or global disturbance of cerebral function lasting for more than 24 hours or leading to death due to no other reason than vascular origin. As there is high incidence of middle cerebral artery stroke, upper limb is more affected than the lower extremity and about 20% of the individual fail to regain any functional use of affected upper extremity. When a stroke patient attempts to move and encounters all the deficits the natural reaction is to compensate with available motor strategies. The measurement of the performance of the affected arm and hand of the patient with hemiplegia is important for determining the goal of intervention as well as outcomes of rehabilitation. So there is a need to have a scale that measures the quality of motor performances specific to the task and identify which elements of the task are missing and how they are compensated. Reaching performance scale is for the identification and quantification of movement pattern and their compensation during reach to grasp task in patients with upper extremity involvement after a stroke.

Materials & Methodology: 30 Hemiplegic patients between age group of 40-60 years who met the inclusion criteria were selected and explained about the study and procedure, and the consent for the study was taken. The Type of study is Inter-rater reliability study (correlation). The Materials used were card board cone, Table, inch tape and a chair.

Procedure: The patients were examined by two Physiotherapists respectively. The patient was seated in a chair with backrest but no arm rest. Reaching performance scale evaluated six components. For all patients both close target [Task I] and Far target [Task II] were assessed and graded. Only reach to grasp component of task are taken into account. The inter-rater reliability to measure the hand and arm function in Reaching Performance scale was statistically analysed by the Mann-Whitney test with P

Result & Conclusion: In this study the reliability between the investigators is very highly significant correlation of closed target (0.951) and P <0.05, Far target (0.946) and P<0.05. So we can conclude that inter rater reliability of RPS scale in assessing arm and hand function is high and hence RPS can also be used to assess the compensatory strategies in stroke patients for an effective intervention.


Keywords


CVA, Stroke, Arm and hand function, Reaching Performance scale, Inter-rater Reliability, Compensatory strategies

References