Clinical Reality of Measuring Upper-Limb Ability in Neurologic Conditions: A Systematic Review

Connell LA, Tyson SF. Clinical reality of measuring upper-limb ability in neurologic conditions: a systematic review. Arch Phys Med Rehabil 2012;93:221-8. Objective: To review the psychometric properties and clinical utility of upper-limb measurement tools in people with neurologic conditions to provide recommendations for practice. Data Sources: MEDLINE, CINAHL, EMBASE, PEDro, and AMED. Study Selection: Independent reviewers searched, selected, and extracted data from articles that assessed reliability, validity, ability to detect change, and clinical utility of measures of the upper limb in adult neurologic conditions. Data Extraction: Measures with good psychometrics and 8 or higher (out of 10) clinical utility scores were recommended. Data Synthesis: The searches identified 31 measures of the upper limb. However, only 2 measures fulfilled all of the psychometric and clinical utility criteria; the Box and Block Test and the Action Research Arm Test. Conclusions: The Box and Block and the Action Research Arm Tests produce robust data and are feasible for use in clinical practice. Future development of new or existing measures should ensure the construct and content validity of the measure is clearly identified, standardized guidelines are easily available, and ensure that it is individualized and contemporary. Attention to measures of upper-limb activity for people who are unable to grip objects is also needed.