Reliability and validity of a newly developed Action Research Arm Test for upper limb function assessment in patients with stroke: A comparison with the conventional version.

The newly developed ARAT demonstrated excellent intra-rater reliability across all subscales and total scores.

• Intraclass correlation coefficients (ICC) ranged from 0.997 to 1.000 for intra-rater reliability
• 95% confidence intervals ranged from 0.995 to 1.000
• Duplicate assessments were conducted with the new ARAT at 15-minute intervals
• Reliability validation group consisted of 33 patients with stroke and hemiparesis

The newly developed ARAT demonstrated excellent inter-rater reliability across all subscales and total scores.

• ICC values ranged from 0.979 to 0.999 for inter-rater reliability
• 95% confidence intervals ranged from 0.963 to 0.999
• Inter-rater evaluation was performed independently using video recordings
• Bland-Altman analysis revealed limits of agreement within clinically acceptable ranges for all measures

The new ARAT demonstrated very strong convergent validity with the Fugl-Meyer Assessment of the Upper Extremity (FMA-UE) and Box and Block Test (BBT).

• Spearman correlation coefficient with FMA-UE was ρ = 0.934 (p < 0.001)
• Spearman correlation coefficient with BBT was ρ = 0.917 (p < 0.001)
• Criterion validity validation group consisted of 31 patients with stroke and hemiparesis
• New and conventional ARAT assessments were administered in randomized order

The new ARAT showed moderate-to-strong convergent validity with grip strength, Motor Activity Log (MAL), and Jikei Assessment Scale for Motor Impairment in Daily Living (JASMID).

• Spearman correlation with grip strength was ρ = 0.683 (p < 0.001)
• Spearman correlations with MAL subscales ranged from ρ = 0.610 to 0.666 (p < 0.001)
• Spearman correlations with JASMID subscales ranged from ρ = 0.806 to 0.808 (p < 0.001)
• Convergent validity was assessed using Spearman correlation coefficients across five established upper limb assessment tools

The study was a single-center cross-sectional study enrolling 64 patients with stroke and hemiparesis who were randomly allocated to reliability or validity validation groups.

• Total sample size was 64 patients with stroke and hemiparesis meeting predefined inclusion criteria
• 33 participants were allocated to the reliability validation group
• 31 participants were allocated to the criterion validity validation group
• Participants were randomly allocated to their respective groups

The newly developed ARAT was created in response to the discontinuation of conventional ARAT imports in Japan, using identical assessment protocols but modified equipment.

• The conventional ARAT import was discontinued in Japan, necessitating a domestic alternative
• The domestically manufactured version maintains identical assessment protocols to the conventional version
• Equipment was modified from the conventional version while preserving the assessment methodology