Reliability and validity of the 15-item Action Research Arm Test with a clinically-informed decision rule.
Purpose: To address the time burden of the widely used 19-item Action Research Arm Test (ARAT), a 15-item version using a decision rule has been proposed. However, the reliability and criterion-related validity of this decision rule have not been formally evaluated. Existing frameworks also do not s...
| Publicado en: | Disability & Rehabilitation Vol. 48; no. 14; pp. 4688 - 4699 |
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| Autores principales: | , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Taylor & Francis Ltd
Jul2026
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=194972742&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 194972742 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09638288 B73 jtl: Disability & Rehabilitation issn: 09638288 maglogo: Y pubinfo: dt: Jul2026 vid: 48 iid: 14 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 194972742 190427443 194972742 194972742 10.1080/09638288.2025.2603843 194972742 ppf: 4688 ppct: 11 formats: tig: atl: Reliability and validity of the 15-item Action Research Arm Test with a clinically-informed decision rule. aug: au: Yoshihara, Shota Sakamoto, Taiichi Amano, Satoru affil: Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Kanagawa, Japan sug: subj: Instrument Validation Arm Physiology Exercise Test, Muscular Evaluation Musculoskeletal System Physiology Evaluation Task Performance and Analysis Decision Making, Clinical Stroke Rehabilitation Recovery Evaluation Human Validation Studies Cross Sectional Studies Nonexperimental Studies Japan Male Female Middle Age Aged Criterion-Related Validity Clinical Assessment Tools Intraclass Correlation Coefficient Item-Total Correlations Funding Source Stroke Patients Academic Medical Centers Treatment Outcomes One-Way Analysis of Variance Confidence Intervals Descriptive Statistics Spearman's Rank Correlation Coefficient Data Analysis Software Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Purpose: To address the time burden of the widely used 19-item Action Research Arm Test (ARAT), a 15-item version using a decision rule has been proposed. However, the reliability and criterion-related validity of this decision rule have not been formally evaluated. Existing frameworks also do not specify the optimal direction of item administration. This study examined the reliability and validity of the 15-item ARAT using a decision rule and a task direction protocol based on Brunnstrom Recovery Stages. Methods: In this cross-sectional study, 30 patients with post-stroke hemiparesis were assessed using the 19-item ARAT and the Fugl-Meyer Assessment (FMA). The 15-item ARAT dataset was derived from the 19-item version. Reliability with and without the decision rule was assessed using intraclass correlation coefficients (ICC), item-level agreement via weighted κ, and criterion-related validity via Spearman's ρ. Results: The decision rules reduced the total number of items from 450 to 226 across all participants. The ICC was 0.997 (95% CI: 0.993–0.999). Item-level agreement was high (κ = 0.88–1.00), although lower for item 6 (κ = 0.68). Correlations with the FMA (ρ = 0.72) and the 19-item ARAT (ρ = 0.96) were strong. Conclusion: This decision rule enhances efficiency without compromising reliability or validity. IMPLICATIONS FOR REHABILITATION: A 15-item version of the Action Research Arm Test (ARAT) with a decision rule has been proposed to reduce the time burden of the original 19-item version. Using the Brunnstrom Recovery Stage to decide where to start the ARAT—beginning with the hardest tasks when both upper extremity and finger stages are ≥ IV, and with the easiest tasks when either is ≤ III—allowed therapists to skip about half of the items without compromising reliability or validity. This clinically informed decision rule may enable more frequent and feasible upper limb assessments for stroke patients in time-limited clinical settings. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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