Validation of the Action Research Arm Test using item response theory in patients after stroke

Koh, Chia-Lin, Hseuh, I-Ping, Wang, Wen-Chung, Sheu,Ching-Fan, Yu, Tzu-Ying, Wang, Chun-Hou and Hsieh,Ching-Lin (2006) Validation of the Action Research Arm Test using item response theory in patients after stroke. Journal of Rehabilitation Medicine, 38 6: 375-380. doi:10.1080/16501970600803252

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Author Koh, Chia-Lin
Hseuh, I-Ping
Wang, Wen-Chung
Yu, Tzu-Ying
Wang, Chun-Hou
Title Validation of the Action Research Arm Test using item response theory in patients after stroke
Journal name Journal of Rehabilitation Medicine   Check publisher's open access policy
ISSN 1650-1977
Publication date 2006-01-01
Year available 2006
Sub-type Article (original research)
DOI 10.1080/16501970600803252
Open Access Status File (Publisher version)
Volume 38
Issue 6
Start page 375
End page 380
Total pages 6
Place of publication Uppsala, 75312 Sweden
Publisher Stiftelsen Rehabiliteringsinformation / Foundation for Rehabilitation Information
Language eng
Subject C1
321024 Rehabilitation and Therapy - Occupational and Physical
730303 Occupational, speech and physiotherapy
Abstract Objective: To validate the unidimensionality of the Action Research Arm Test (ARAT) using Mokken analysis and to examine whether scores of the ARAT can be transformed into interval scores using Rasch analysis. Subjects and methods: A total of 351 patients with stroke were recruited from 5 rehabilitation departments located in 4 regions of Taiwan. The 19-item ARAT was administered to all the subjects by a physical therapist. The data were analysed using item response theory by non-parametric Mokken analysis followed by Rasch analysis. Results: The results supported a unidimensional scale of the 19-item ARAT by Mokken analysis, with the scalability coefficient H = 0.95. Except for the item pinch ball bearing 3rd finger and thumb'', the remaining 18 items have a consistently hierarchical order along the upper extremity function's continuum. In contrast, the Rasch analysis, with a stepwise deletion of misfit items, showed that only 4 items (grasp ball'', grasp block 5 cm(3)'', grasp block 2.5 cm(3)'', and grip tube 1 cm(3)'') fit the Rasch rating scale model's expectations. Conclusion: Our findings indicated that the 19-item ARAT constituted a unidimensional construct measuring upper extremity function in stroke patients. However, the results did not support the premise that the raw sum scores of the ARAT can be transformed into interval Rasch scores. Thus, the raw sum scores of the ARAT can provide information only about order of patients on their upper extremity functional abilities, but not represent each patient's exact functioning.
Keyword psychometrics
cerebrovascular accident
Upper Extremity Function
Motor Function
Rasch Analysis
Q-Index Code C1
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2007 Higher Education Research Data Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 22 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 24 times in Scopus Article | Citations
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Created: Wed, 15 Aug 2007, 19:27:48 EST