Psychometric properties of the simple test for evaluating hand function in patients with stroke.

OBJECTIVE: The simple test for evaluating hand function (STEF) is widely used for clinical evaluation of upper extremity function in Japan. However, except for test-re-test reliability, its psychometric properties have not been investigated. The aim of this study is to explore its internal consistency, concurrent validity and responsiveness in patients with sub-acute stroke. DESIGN: This was a prospective longitudinal study. PATIENTS: Thirty-four inpatients who had suffered hemiparetic stroke within 60 days of participation were enrolled. METHODS: To investigate its internal consistency and responsiveness, they were assessed with the STEF and Action Research Arm Test (ARAT) at admission and 3 weeks later. To explore its concurrent validity, the Fugl-Meyer Assessment (FMA), Motor Activity Log (MAL) and Functional Independence Measure (FIM™) were also evaluated at admission. RESULTS: The Cronbach's alpha for the STEF was 0.98-0.99, indicating excellent internal consistency. The STEF score strongly correlated with the ARAT, FMA and MAL scores and moderately with the FIM™ score. Effect sizes and the standardized response mean were 0.27 and 0.52 for the STEF and 0.30 and 0.95 for the ARAT, respectively. CONCLUSION: This study indicates that the STEF is reliable, valid and sensitive to changes when applied to patients with sub-acute stroke.

Effectiveness of hybrid assistive neuromuscular dynamic stimulation therapy in patients with subacute stroke: a randomized controlled pilot trial.

BACKGROUND AND OBJECTIVE: Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy was devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The aim of this study is to assess the effectiveness of HANDS therapy for patients with subacute stroke. METHODS: The participants were 24 inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Patients were randomly assigned to 2 groups. The HANDS group (n = 12) used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group (n = 12) wore a wrist splint alone. All patients received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL). RESULTS: In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in distal (wrist/hand) portion of the FMA (P < .01) and improvement of the ARAT (P < .05). The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted. CONCLUSION: HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation.