In a previous research project the interrater-reliability and comprehensibility of the AHAS have already been tested and cut-off values for the Fugl-Meyer-Assessment have been determined Therefore the AHAS provides a simple, comprehensible categorization of the degree of severity of arm-hand activities after a stroke at the ICF-activity level in five categories: no activities, fixing objects, grasp/release, fine arm/hand use and near normal arm/hand activities.
In this study we investigated correlation between the Arm-Hand-Activities-Scale and the Action-Research-Arm-test (ARAT) as gold standard for measuring arm-hand activities. Stroke patients in subacute phase were classified by the AHAS and tested with the ARAT at t0. Sensitivity-to-change for the AHAS was measured at inclusion and after 4 weeks in-patient rehabilitation (t1).
71 (45 male) patients (average age: 69 years) with a first stroke three to nine weeks before inclusion participated in this study. At baseline, five patients were categorized as "no activities", one patient to "fixing objects", eight to "grasp/release", 27 to " fine arm/hand use " and 30 patients to "near normal arm/hand activity". The scatterplot shows overlaps between the individual AHAS categories. We found a strong Spearman-correlation (r = 0.926; p 0.001) between ARAT sum score and AHAS. The Wilcoxon-sign-rank test for sensitivity-to-change was also significant (z = -5.29; p 0.001).
The results show that higher values in the ARAT are associated with higher categorization in the AHAS. Thus the AHAS measures change in the context of arm/hand rehabilitation and provides a quick and simple classification system for everyday clinical practice to assess the severity of arm/hand activities after a stroke. This can significantly reduce the examination time for patients with arm-hand paresis. Assignment to suitable treatment strategies in accordance with guidelines are thus made much easier and incorrect assignments due to inadequate and/or missing classifications of the degree of severity of arm-hand activities can be minimized.
International implementation of the AHAS in acute hospitals and neurological rehabilitation centres is planned for the future. Further studies are required to substantiate the AHAS scientifically.
arm function
assessment
