Inter-rater reliability and validity of the Action Research arm test in stroke patients

Background and purpose: the Action Research arm test (ARAT) was constructed for assessing recovery of upper extremity function after cortical injury. The objective of the study was to verify the inter-rater reliability and validity of the ARAT in stroke patients. Methods: 50 stroke patients participated in the study. For the purpose of inter-rater study the ARAT was administered by three experienced raters on each patient within a 3-day period. Validity was assessed by comparing the patients' scores on the ARAT with those obtained for the other well-validated measurements evaluating upper extremity motor impairment and disability. Results: intra-class correlation coefficient (ICC) for the total score was 0.98 indicating very high inter-rater reliability. ICCs were also very high in each of the subscales, The score of the ARAT was closely correlated with that of the upper extremity part of the motor assessment scale, the arm sub-score of the motricity index and the upper extremity movements of the modified motor assessment chart (Pearson r = 0.96, 0.87 and 0.94, respectively). Conclusion: the preliminary results of this study support the value of the ARAT for measuring recovery of arm-hand function in stroke patients.