COSMIN database

Evaluation of functional outcome measures for the hemiparetic upper limb: a systematic review

Ashford, S., Slade, M., Malaprade, F., and Turner-Stokes, L.
OBJECTIVE: To identify valid and reliable outcome measures reflective of "real-life" active and passive function for application following focal rehabilitation interventions in the hemiparetic upper limb after stroke or brain injury.

METHODS: A systematic review of the literature, incorporating a wide-based search including electronic databases, primary reports, abstracts and conference proceedings, was undertaken to identify measures, followed by a literature-based evaluation of the psychometric properties.

RESULTS: Six measures met the review selection criteria, although 4 were different versions of the Motor Activity Log. None of the measures met all the psychometric evaluation criteria. The tools effectively formed a hierarchy with the ABILHAND and Motor Activity Log representing quite thoroughly evaluated tools of higher level "active function". The Leeds Adult Spasticity Impact Scale addressed lower level tasks and passive function, but had little published psychometric evaluation.

CONCLUSION: As yet there is no single valid and reliable outcome measure available to capture the full range of "real-life" function in the hemiparetic upper limb. Validated tools are particularly required for passive and lower level function. The selection of measures for clinical evaluation will depend on the patient's level of function and goals for treatment.
J Rehabil Med
1651-2081 (Electronic)
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the nervous system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
2 - Interviews
6 - Clinical rating scales
LASIS - Leeds Adult Spasticity Impact Scale
MAL-12 - Reduced Upper Extremity Motor Activity Log
MAL-14 - Motor Activity Log-14 item
MAL-26 - Motor Activity Log-26 item
MAL-28 - Motor Activity Log-28 item