COSMIN database

Assessment of the measurement properties of the post stroke motor function instruments available in Brazil: a systematic review

Lima, E., Teixeira-Salmela, L. F., Simoes, L., Guerra, A. C., and Lemos, A.
BACKGROUND: While there are several instruments in Brazil that measure motor function in patients after stroke, it is unknown whether the measurement properties of these instruments are appropriate.

OBJECTIVE: To identify the motor function instruments available in Brazil for patients after stroke. To assess the methodological quality of the studies and the results related to the measurement properties of these instruments.

METHOD: Two independent reviewers conducted searches on PubMed, LILACS, CINAHL, Web of Science, and Scopus. Studies that aimed to cross-culturally adapt an existing instrument or create a Brazilian instrument and test at least one measurement property related to motor function in patients after stroke were included. The methodological quality of these studies was checked by the COSMIN checklist with 4-point rating scale and the results of the measurement properties were analyzed by the criteria developed by Terwee et al.

RESULTS: A total of 11 instruments were considered eligible, none of which were created in Brazil. The process of cross-cultural adaptation was inadequate in 10 out of 11 instruments due to the lack of back-translation or due to inappropriate target population. All of the instruments presented flaws in the measurement properties, especially reliability, internal consistency, and construct validity.

CONCLUSION: The flaws observed in both cross-cultural adaptation process and testing measurement properties make the results inconclusive on the validity of the available instruments. Adequate procedures of cross-cultural adaptation and measurement properties of these instruments are strongly needed.
Braz J Phys Ther
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Seniors (65+)
Diseases of and symptoms related to the circulatory system
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
1 - Questionnaires
2 - Interviews
4 - Performance-based tests
6 - Clinical rating scales
FMA - Fugl-Meyer Motor Assessment   
JTHFT - Jebsen Taylor Hand Function Test [alias: JTT]   
MAL-28 - Motor Activity Log-28 item
MAS - Motor Assessment Scale   
NIHSS - National Institutes of Health Stroke Scale   
PASS - Postural Assessment Scale for Stroke patients
RMI - Rivermead Mobility Index   
TEMPA - Test Évaluant les Membres supérieurs des Personnes Âgées
TIS - Trunk Impairment Scale (two different scales; one scale developed by Verheyden et al 2004; one scale developed by Fujiwara et al. 2004 )   
WMFT - Wolf Motor Function Test