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Clinical interpretation and cutoff scores for manual ability measured by the ABILHAND questionnaire in people with stroke

Ekstrand, Elisabeth LU orcid ; Alt Murphy, Margit and Sunnerhagen, Katharina S. (2023) In Topics in Stroke Rehabilitation 30(1). p.21-31
Abstract

Background: The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability. Objectives: To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke. Methods: This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed... (More)

Background: The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability. Objectives: To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke. Methods: This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed functioning was assessed by Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) at 3 months after stroke. Receiver operating characteristic curve, sensitivity, and specificity analyses were used to determine the cutoffs. Results: The overall discriminating accuracy was excellent (AUC > 0.90) for most of the cutoffs and sensitivity and specificity values ranged from 0.73 to 1.0. The ABILHAND cutoff score 1.78 discriminated well between low and good functioning resulting in a 95% match with SIS Hand and 87.5% match with ARAT and FMA-UE. Conclusions: The determined cutoff scores of the ABILHAND, validated through established upper extremity assessments, will provide a useful tool to clinicians when interpreting the logit scores and when selecting individualized treatment options. ABILHAND matched well with self-reported SIS Hand, but discrepancies found with observed scales implies that self-perceived assessments should be complemented with observed assessments.

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author
; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Activities of daily living, outcome assessment, self report, stroke, upper extremity
in
Topics in Stroke Rehabilitation
volume
30
issue
1
pages
21 - 31
publisher
Maney Publishing
external identifiers
  • pmid:34590536
  • scopus:85116362269
ISSN
1074-9357
DOI
10.1080/10749357.2021.1978631
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2021 Taylor & Francis Group, LLC.
id
b91aaac1-54df-440d-870c-e30ed54d91c2
date added to LUP
2021-10-25 15:15:50
date last changed
2024-06-15 19:06:48
@article{b91aaac1-54df-440d-870c-e30ed54d91c2,
  abstract     = {{<p>Background: The ABILHAND questionnaire is recommended to assess perceived manual ability after stroke; however, more knowledge on interpretability is needed to improve the clinical applicability. Objectives: To determine clinically meaningful cutoff scores for different levels of perceived manual ability, assessed by ABILHAND, corresponding to established observed and perceived upper extremity assessments post stroke. Methods: This cross-sectional study, part of the Stroke Arm Longitudinal Study (SALGOT) at the University of Gothenburg, included 80 participants with upper extremity impairments after stroke. The self-reported upper extremity functioning was assessed with ABILHAND and Stroke Impact Scale Hand (SIS Hand), and the observed functioning was assessed by Fugl-Meyer Assessment for Upper Extremity (FMA-UE) and Action Research Arm Test (ARAT) at 3 months after stroke. Receiver operating characteristic curve, sensitivity, and specificity analyses were used to determine the cutoffs. Results: The overall discriminating accuracy was excellent (AUC &gt; 0.90) for most of the cutoffs and sensitivity and specificity values ranged from 0.73 to 1.0. The ABILHAND cutoff score 1.78 discriminated well between low and good functioning resulting in a 95% match with SIS Hand and 87.5% match with ARAT and FMA-UE. Conclusions: The determined cutoff scores of the ABILHAND, validated through established upper extremity assessments, will provide a useful tool to clinicians when interpreting the logit scores and when selecting individualized treatment options. ABILHAND matched well with self-reported SIS Hand, but discrepancies found with observed scales implies that self-perceived assessments should be complemented with observed assessments.</p>}},
  author       = {{Ekstrand, Elisabeth and Alt Murphy, Margit and Sunnerhagen, Katharina S.}},
  issn         = {{1074-9357}},
  keywords     = {{Activities of daily living; outcome assessment; self report; stroke; upper extremity}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{21--31}},
  publisher    = {{Maney Publishing}},
  series       = {{Topics in Stroke Rehabilitation}},
  title        = {{Clinical interpretation and cutoff scores for manual ability measured by the ABILHAND questionnaire in people with stroke}},
  url          = {{http://dx.doi.org/10.1080/10749357.2021.1978631}},
  doi          = {{10.1080/10749357.2021.1978631}},
  volume       = {{30}},
  year         = {{2023}},
}