To overcome this gap, we aimed to develop and evaluate the inta- and inter-rater reliability and validity of a new observation-based scale, the Drinking Task Assessment (DTA), designed to assess quality of movement in task performance in people with stroke.
The established kinematic analysis of drinking task (Alt Murphy et al 2011) was used to guide the development of DTA and the previously developed Reaching Performance Task (Levin et al. 2004) was used as starting templet. The components of DTA measure movement time and movement quality (smoothness, trunk, shoulder, elbow and grasp movements) on a 4-level ordinal scale and it takes approximately 5-10 minutes to perform. Thirty participants (mean age 62 years) with chronic stroke were assessed independently by two therapists. The assessments were also video recorded. Intra-class Correlation (ICC), Standard error of Measurement (SEM) and minimal real difference (MRD), Weighted kappa, percentage of agreement and Svensson method were used for reliability assessment. Motion capture-based kinematics and established clinical scales were used to evaluate validity.
The absolute SEM and MRD for movement time were 0.4 and 1 seconds (11%), respectively. The ICC (≥0.93) and Weighted kappa (0.71-1.0) showed good to excellent agreement for intra- and interrater reliability. DTA showed strong correlations with Fugl-Meyer Assessment (0.74), Action Research Arm Test (0.93) and kinematic measures of smoothness (0.93), trunk displacement (0.91), elbow extension (0.73), and shoulder movements (0.56) indicating good construct validity.
The new DTA proves to be reliable and valid tool for assessment of movement quality during task performance after stroke. The new scale allows a standardized observation-based assessment of the key kinematic features relevant for people with hemiparesis to be used in clinical settings.
The scale can be a valuable alternative for assessment when a more advanced kinematic analysis is not clinically feasible or required.
assessment
upper extremity
