Task Oriented Training Activities Post Stroke Will Produce Measurable Alterations in Brain Plasticity Concurrent with Skill Improvement.

BACKGROUND: Task-oriented training with upper extremity (UE) skilled movements has been established as a method to regain function post stroke. Although improved UE function has been shown after this type of therapy, there is minimal evidence that brain plasticity is associated with this training. The accelerated skill acquisition program (ASAP) is an example of an approach for promoting UE function using targeting movements. OBJECTIVE: To investigate the effects of a single 2-hour session of ASAP in individuals with stroke on measures of brain plasticity as represented by corticospinal excitability (CE) and determine associations with reach-to-grasp (RTG) performance. METHODS: Eighteen post-acute stroke patients were randomized to two groups. Experimental group (n = 9) underwent ASAP for 2 hours, while the control group (n = 9) received dose equivalent usual and customary care. Both groups were evaluated for CE and RTG performance prior to the session and then four times after training: immediately, 1 day, 6 days, and 12 days. RESULTS: Significant alterations in CE were found in the peak-to-peak of Motor Evoked Potential amplitude of elbow and wrist extensor muscles in the lesioned hemisphere. The experimental group also demonstrated improved execution (shortened total movement time, TMT), feed-forward mechanism (deceleration time, DT) and planning (lengthened relative time to maximum hand aperture, RTApmax) compared to the control group. CONCLUSION: Alterations in brain plasticity occur concurrently with improvements in RTG performance in post-acute stroke patients with mild impairment after a single 2-hour session of task-oriented training and persist for at least 12 days.

Hand Rehabilitation Learning System With an Exoskeleton Robotic Glove.

This paper presents a hand rehabilitation learning system, the SAFE Glove, a device that can be utilized to enhance the rehabilitation of subjects with disabilities. This system is able to learn fingertip motion and force for grasping different objects and then record and analyze the common movements of hand function including grip and release patterns. The glove is then able to reproduce these movement patterns in playback fashion to assist a weakened hand to accomplish these movements, or to modulate the assistive level based on the user's or therapist's intent for the purpose of hand rehabilitation therapy. Preliminary data have been collected from healthy hands. To demonstrate the glove's ability to manipulate the hand, the glove has been fitted on a wooden hand and the grasping of various objects was performed. To further prove that hands can be safely driven by this haptic mechanism, force sensor readings placed between each finger and the mechanism are plotted. These experimental results demonstrate the potential of the proposed system in rehabilitation therapy.

Effect of a one-semester conditioning class on physiological characteristics of college students.

Long-term exercise is known to have positive effects on the health of adults. Some college "activity" courses are designed to give participants exposure to, and practice with, safe exercise techniques. Whether these 1-semester courses, usually 12-14 weeks, are sufficient to alter physiological characteristics, such as blood pressure or strength, has not been established. Therefore, the purpose of our investigation was to evaluate physiological and performance measures in college students to determine whether changes would result after 14 weeks of a general conditioning activity course. This study involved 79 students from several sections of exercise and conditioning classes at our university. Classes included a variety of fitness- and strength-oriented exercises. Physiological and performance measurements were collected in weeks 2 (pretest) and 14 (posttest), and compared pre with post using paired t-tests subject to Bonferroni correction (significant p < 0.0055). There were significant improvements in resting heart rate (HR) (73 vs. 70 b·min, p < 0.002), hand grip strength (250 vs. 272 N, p < 0.001), push-ups (29 vs 37, p < 0.001), sit-ups (32 vs. 35, p < 0.001), and step test HR recovery (122 vs. 110 b·min, p < 0.001). Systolic and diastolic blood pressures, body weight, and percent body fat did not change. These results suggest that 14 weeks of regular exercise in an organized college-based activity class can result in significant improvements in some measures of fitness and strength in college-aged participants.

Predictors of functional shoulder recovery at 1 and 12 months after breast cancer surgery.

The objective of this study are (1) to determine if upper extremity function, as represented by shoulder ROM, self-reported symptoms and upper extremity functional limitations in activities of daily living could be predictively related to demographic and cancer characteristics post-surgery for breast cancer. And (2) to examine if variables related to early onset impairment contribute to late onset impairments in women after breast cancer surgery. Subjects were assessed preoperatively and 1, 3, 6, 9, and 12+ months post breast cancer surgery for impairments and symptoms and at 12+ months for shoulder functional limitations using a physical therapy surveillance model. Body weight, shoulder ROM, manual muscle testing, and upper limb volume were recorded. At 12+ months, the Harvard Alumni Health Study Physical Activity Questionnaire, and an Upper Limb Disability Questionnaire were administered. Symptoms and ROM impairments were compared by functional limitations. Characteristics significantly associated with early ROM impairment (but not later impairment) were axillary lymph node dissection, removal of ≥15 nodes, mastectomy surgery and stage II breast cancer. Positive nodes, older age, and BMI≥25 were significantly associated with reduced shoulder ROM at 12+ months. At 12+ months, only 10 % of the patients experienced ROM impairments while rates of self-reported symptoms in the affected upper extremity at 12+ months were as follows: pain-49%, weakness-47.1%, numbness-55.9%, feeling tired-42.5%. The majority of patients used the affected upper extremity for reaching without limitation, but ≥35% reported limitation with household chores, carrying and lifting. Difficulty carrying and lifting could be predicted by BMI≥25 and use of the dominant affected upper limb. Different factors are associated with early versus later ROM loss. Symptoms reported by breast cancer survivors are frequently associated with functional limitations in upper extremity tasks and warrant intervention. Physical therapy using a prospective surveillance model of care may reduce severity of ROM loss, symptoms and functional upper extremity limitations 1 year after breast cancer surgery.

Breast cancer-related lymphedema: comparing direct costs of a prospective surveillance model and a traditional model of care.

Secondary prevention involves monitoring and screening to prevent negative sequelae from chronic diseases such as cancer. Breast cancer treatment sequelae, such as lymphedema, may occur early or late and often negatively affect function. Secondary prevention through prospective physical therapy surveillance aids in early identification and treatment of breast cancer-related lymphedema (BCRL). Early intervention may reduce the need for intensive rehabilitation and may be cost saving. This perspective article compares a prospective surveillance model with a traditional model of impairment-based care and examines direct treatment costs associated with each program. Intervention and supply costs were estimated based on the Medicare 2009 physician fee schedule for 2 groups: (1) a prospective surveillance model group (PSM group) and (2) a traditional model group (TM group). The PSM group comprised all women with breast cancer who were receiving interval prospective surveillance, assuming that one third would develop early-stage BCRL. The prospective surveillance model includes the cost of screening all women plus the cost of intervention for early-stage BCRL. The TM group comprised women referred for BCRL treatment using a traditional model of referral based on late-stage lymphedema. The traditional model cost includes the direct cost of treating patients with advanced-stage lymphedema. The cost to manage early-stage BCRL per patient per year using a prospective surveillance model is $636.19. The cost to manage late-stage BCRL per patient per year using a traditional model is $3,124.92. The prospective surveillance model is emerging as the standard of care in breast cancer treatment and is a potential cost-saving mechanism for BCRL treatment. Further analysis of indirect costs and utility is necessary to assess cost-effectiveness. A shift in the paradigm of physical therapy toward a prospective surveillance model is warranted.

The effects of multiaxial and uniaxial unstable surface balance training in college athletes.

The purpose of this study was to compare the effects of 2 different types of unstable surface balance training (uniaxial on a rocker board [RB] and multiaxial on a dynadisc [DD]) on balance in division 1 collegiate athletes in sports that are at high risk for ankle sprains. Subjects (n = 36) consisted of male soccer players and female volleyball and soccer players who were equally and randomly assigned to 1 of 3 groups (CON, DD, and RB). Balance training consisting of balancing on 1 leg on either the RB or DD, while repeatedly catching a 1-kg ball was performed 3 times per week for 4 weeks. Balance was tested with the Star Excursion Balance Test (SEBT) before, halfway through, and at the completion of the balance training. Control (CON) subjects also were given the balance test but did not participate in the training. A 3-way repeated analysis of variance revealed that no group individually changed SEBT scores from pre (CON, 0.98 +/- 0.086; DD, 0.98 +/- 0.083; RB, 0.97 +/- 0.085) to post (CON, 1.00 +/- 0.090; DD, 1.01 +/- 0.088; RB, 1.02 +/- 0.068) after balance training. When the 2 treatment groups were combined (DD and RB), the p value decreased and came closer to significance (p = 0.136). When all 3 groups were combined, there was a significant difference in SEBT scores from pretraining (CON + DD + RB; 0.98 +/- 0.085) to posttraining (CON + DD + RB; 1.01 +/- 0.082), which likely indicates low statistical power. The increase in physical activity the subjects experienced during the return to in-season activity, may have contributed to the significant differences in SEBT scores over time but not between DD or RB training. Therefore, a threshold level of physical activity may exist that is necessary to maintain balance during the off-season.

Pre-operative assessment enables early diagnosis and recovery of shoulder function in patients with breast cancer.

In order to determine the extent and time course of upper limb impairment and dysfunction in women being treated for breast cancer (BC), and followed prospectively, a novel physical therapy surveillance model post-treatment was used. Subjects included adult women with newly diagnosed, untreated, unilateral, Stage I to III BC, and normal physiological and biomechanical shoulder function. Subjects were excluded if they had a previous history of BC, or prior injury or surgery of the affected upper limb. Measurements included body weight, shoulder ranges of motion (ROM), manual muscle tests, pain levels, upper limb volume, and an upper limb disability questionnaire (ULDQ). Measurements were taken at baseline (pre-surgery), and 1, 3-6, and 12 months post-surgery. All subjects received pre-operative education and exercise instruction and specific physical therapy (PT) protocol after surgery including ROM and strengthening exercises. All measures of function were significantly reduced 1 month post-surgery, but most recovered to baseline levels by 1-year post-surgery. Some subjects developed signs of lymphedema 3-12 months post-surgery, but this did not compromise function. Shoulder abduction, flexion, and external rotation, but not internal rotation ROM, were associated with the ULDQ. Most women in this cohort undergoing surgery for BC who receive PT intervention may expect a return to baseline ROM and strength by 3 months. Those who do not reach baseline, often continue to improve and reach their pre-operative levels by 1-year post-surgery. Lymphedema develops independently of shoulder function 3-12 months post-surgery, necessitating continued monitoring. A prospective physical therapy model of surveillance allows for detection of early and later onset of impairment following surgery for BC in this specific cohort of patients.

Comparison of acute exercise responses between conventional video gaming and isometric resistance exergaming.

Exergaming is a relatively new type of entertainment that couples physical activity and video gaming. To date, research that has focused on the physiologic responses to exergaming has been focused exclusively on aerobic-type activities. The purpose of this project was to describe the acute exercise responses (i.e., oxygen uptake [VO(2)], heart rate, and rate of perceived exertion [RPE]) to exergaming using full-body isometric muscle resistance and to determine whether these responses are different during single- versus opponent-based play. Male subjects (n = 32) were randomly and equally divided into either an experimental (EXP) or control (CON) group. Acute exercise responses VO(2), heart rate, and RPE) were measured in all subjects during both solo- and opponent-based video game play. Subjects in the EXP group played using a controller that relied on full-body isometric muscle resistance to manipulate the on-screen character, whereas CON subjects used a conventional handheld controller. During solo play, the EXP group exhibited significantly higher values for VO(2) (9.60 +/-0.50 mL/kg/min) and energy expenditure (3.50 +/- 0.14 kcal/min) than the CON group VO(2) 5.05 +/- 0.16 mL/kg/min; energy expenditure 1.92 +/- 0.07 kcal/min). These changes occurred with no significant differences in RPE or heart rate between the groups. These results suggest that whole-body isometric exergaming results in greater energy expenditure than conventional video gaming, with no increase in perceived exertion during play. This could have important implications regarding long-term energy expenditure in gamers.

Novel applications of ultrasound technology to visualize and characterize myofascial trigger points and surrounding soft tissue.

OBJECTIVE: To apply ultrasound (US) imaging techniques to better describe the characteristics of myofascial trigger points (MTrPs) and the immediately adjacent soft tissue. DESIGN: Four sites in each patient were labeled based on physical examination as active myofascial trigger points (A-MTrPs; spontaneously painful), latent myofascial trigger points (L-MTrPs; nonpainful), or normal myofascial tissue. US examination was performed on each subject by a team blinded to the physical findings. A 12 approximately 5MHz US transducer was used. Vibration sonoelastography (VSE) was performed by color Doppler variance imaging while simultaneously inducing vibrations (approximately 92Hz) with a handheld massage vibrator. Each site was assigned a tissue imaging score as follows: 0, uniform echogenicity and stiffness; 1, focal hypoechoic region with stiff nodule; 2, multiple hypoechoic regions with stiff nodules. Blood flow in the neighborhood of MTrPs was assessed using Doppler imaging. Each site was assigned a blood flow waveform score as follows: 0, normal arterial flow in muscle; 1, elevated diastolic flow; 2, high-resistance flow waveform with retrograde diastolic flow. SETTING: Biomedical research center. PARTICIPANTS: Subjects (N=9) meeting Travell and Simons' criteria for MTrPs in a taut band in the upper trapezius. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: MTrPs were evaluated by (1) physical examination, (2) pressure algometry, and (3) three types of US imaging including gray-scale (2-dimensional [2D] US), VSE, and Doppler. RESULTS: MTrPs appeared as focal, hypoechoic regions on 2D US, indicating local changes in tissue echogenicity, and as focal regions of reduced vibration amplitude on VSE, indicating a localized, stiff nodule. MTrPs were elliptical, with a size of .16+/-.11 cm(2). There were no significant differences in size between A-MTrPs and L-MTrPs. Sites containing MTrPs were more likely to have a higher tissue imaging score compared with normal myofascial tissue (P<.002). Small arteries (or enlarged arterioles) near A-MTrPs showed retrograde flow in diastole, indicating a highly resistive vascular bed. A-MTrP sites were more likely to have a higher blood flow score compared with L-MTrPs (P<.021). CONCLUSIONS: Preliminary findings show that, under the conditions of this investigation, US imaging techniques can be used to distinguish myofascial tissue containing MTrPs from normal myofascial tissue (lacking trigger points). US enables visualization and some characterization of MTrPs and adjacent soft tissue.

Reliability, validity, and precision of an active stereophotogrammetry system for three-dimensional evaluation of the human torso.

To determine the reliability, stability, validity and precision of a stereophotogrammetry (SP) system for use in quantifying the complex three-dimensional structure of the human torso, we performed assessments of the system using images of geometric solids and a human-form mannequin. Analysis of geometric solids revealed excellent intra- and interrater reliability of the system for linear, surface area and volume measurements (r>0.99, P<0.001). Overall, no significant difference was found between SP and manual measurements (F=4.23, P>0.06). The system exhibited excellent stability in images of the mannequin over time (r>0.99). The limit of precision (error>5%) of the system to detect objects on the surface of the mannequin was estimated at an object size of 23.5cm(2) for surface area and 32mL for volume. These results demonstrate the capability of SP of the torso to be used as a reliable, stable and valid measure of torso morphology to be applied as a clinical outcome tool in studies of bony and soft tissue pathologies such as scoliosis, rib deformities, obesity or edema.

The various perceptions of distance: an alternative view of how effort affects distance judgments.

D. R. Proffitt and colleagues (e. g., D. R. Proffitt, J. Stefanucci, T. Banton, & W. Epstein, 2003) have suggested that objects appear farther away if more effort is required to act upon them (e.g., by having to throw a ball). The authors attempted to replicate several findings supporting this view but found no effort-related effects in a variety of conditions differing in environment, type of effort, and intention to act. Although they did find an effect of effort on verbal reports when participants were instructed to take into account nonvisual (cognitive) factors, no effort-related effect was found under apparent- and objective-distance instruction types. The authors' interpretation is that in the paradigms tested, effort manipulations are prone to influencing response calibration because they encourage participants to take nonperceptual connotations of distance into account while leaving perceived distance itself unaffected. This in no way rules out the possibility that effort influences perception in other contexts, but it does focus attention on the role of response calibration in any verbal distance estimation task.

Acute effects of static, dynamic, and proprioceptive neuromuscular facilitation stretching on muscle power in women.

The purpose of this study was to investigate the acute effects of 3 types of stretching-static, dynamic, and proprioceptive neuromuscular facilitation (PNF)-on peak muscle power output in women. Concentric knee extension power was measured isokinetically at 60 degrees x s(-1) and 180 degrees x s(-1) in 12 healthy and recreationally active women (mean age +/- SD, 24 +/- 3.3 years). Testing occurred before and after each of 3 different stretching protocols and a control condition in which no stretching was performed. During 4 separate laboratory visits, each subject performed 5 minutes of stationary cycling at 50 W before performing the control condition, static stretching protocol, dynamic stretching protocol, or PNF protocol. Three submaximal warm-up trials preceded 3 maximal knee extensions at each testing velocity. A 2-minute rest was allowed between testing at each velocity. The results of the statistical analysis indicated that none of the stretching protocols caused a decrease in knee extension power. Dynamic stretching produced percentage increases (8.9% at 60 degrees x s(-1) and 6.3% at 180 degrees x s(-1)) in peak knee extension power at both testing velocities that were greater than changes in power after static and PNF stretching. The findings suggest that dynamic stretching may increase acute muscular power to a greater degree than static and PNF stretching. These findings may have important implications for athletes who participate in events that rely on a high level of muscular power.

A comparison of different assessment techniques for measuring foot and ankle volume in healthy adults.

BACKGROUND: Foot and ankle volume may be an important measurement for conditions such as lower-extremity trauma or pathologic abnormalities. Water volumetry, often used for this measure, is accurate but not always convenient. We used figure-of-eight tape measurement, prism approximation, foot size measurement (Brannock device), and optoelectric measurement (Perometer) with the standard of water volumetry to compare foot and ankle volumes. METHODS: All five techniques were used to measure both the feet and ankles of ten asymptomatic men and women. Reliability was determined by repeating several trials, and validity was determined by comparing all of the techniques with water volumetry (the established standard). Regression equations were found that related each technique to water volumetry. RESULTS: All of the techniques were reliable (intraclass correlation coefficient[3,1] = 0.96-0.99). The figure-of-eight technique showed the highest agreement with water volumetry (R(2) = 0.96), and the prism method, the lowest (R(2) = 0.73). CONCLUSIONS: Although any of these techniques should be acceptable for monitoring foot and ankle volume in normal limbs, the figure-of-eight method comes closest to reproducing the results of water volumetry. We believe that this technique would also be best in the presence of foot deformities, but this remains to be studied.

Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points.

OBJECTIVES: To investigate the biochemical milieu of the upper trapezius muscle in subjects with active, latent, or absent myofascial trigger points (MTPs) and to contrast this with that of the noninvolved gastrocnemius muscle. DESIGN: We used a microanalytic technique, including needle insertions at standardized locations in subjects identified as active (having neck pain and MTP), latent (no neck pain but with MTP), or normal (no neck pain, no MTP). We followed a predetermined sampling schedule; first in the trapezius muscle and then in normal gastrocnemius muscle, to measure pH, bradykinin, substance P, calcitonin gene-related peptide, tumor necrosis factor alpha, interleukin 1beta (IL-1beta), IL-6, IL-8, serotonin, and norepinephrine, using immunocapillary electrophoresis and capillary electrochromatography. Pressure algometry was obtained. We compared analyte concentrations among groups with 2-way repeated-measures analysis of variance. SETTING: A biomedical research facility. PARTICIPANTS: Nine healthy volunteer subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Preselected analyte concentrations. RESULTS: Within the trapezius muscle, concentrations for all analytes were higher in active subjects than in latent or normal subjects (P<.002); pH was lower (P<.03). At needle insertion, analyte concentrations in the trapezius for the active group were always higher (pH not different) than concentrations in the gastrocnemius muscle. At all times within the gastrocnemius, the active group had higher concentrations of all analytes than did subjects in the latent and normal groups (P<.05); pH was lower (P<.01). CONCLUSIONS: We have shown the feasibility of continuous, in vivo recovery of small molecules from soft tissue without harmful effects. Subjects with active MTPs in the trapezius muscle have a biochemical milieu of selected inflammatory mediators, neuropeptides, cytokines, and catecholamines different from subjects with latent or absent MTPs in their trapezius. These concentrations also differ quantitatively from a remote, uninvolved site in the gastrocnemius muscle. The milieu of the gastrocnemius in subjects with active MTPs in the trapezius differs from subjects without active MTPs.

An in vivo microanalytical technique for measuring the local biochemical milieu of human skeletal muscle.

Myofascial pain associated with myofascial trigger points (MTrPs) is a common cause of nonarticular musculoskeletal pain. Although the presence of MTrPs can be determined by soft tissue palpation, little is known about the mechanisms and biochemical milieu associated with persistent muscle pain. A microanalytical system was developed to measure the in vivo biochemical milieu of muscle in near real time at the subnanogram level of concentration. The system includes a microdialysis needle capable of continuously collecting extremely small samples (approximately 0.5 microl) of physiological saline after exposure to the internal tissue milieu across a 105-microm-thick semi-permeable membrane. This membrane is positioned 200 microm from the tip of the needle and permits solutes of <75 kDa to diffuse across it. Three subjects were selected from each of three groups (total 9 subjects): normal (no neck pain, no MTrP); latent (no neck pain, MTrP present); active (neck pain, MTrP present). The microdialysis needle was inserted in a standardized location in the upper trapezius muscle. Due to the extremely small sample size collected by the microdialysis system, an established microanalytical laboratory, employing immunoaffinity capillary electrophoresis and capillary electrochromatography, performed analysis of selected analytes. Concentrations of protons, bradykinin, calcitonin gene-related peptide, substance P, tumor necrosis factor-alpha, interleukin-1beta, serotonin, and norepinephrine were found to be significantly higher in the active group than either of the other two groups (P < 0.01). pH was significantly lower in the active group than the other two groups (P < 0.03). In conclusion, the described microanalytical technique enables continuous sampling of extremely small quantities of substances directly from soft tissue, with minimal system perturbation and without harmful effects on subjects. The measured levels of analytes can be used to distinguish clinically distinct groups.

Navicular drop measurement in people with rheumatoid arthritis: interrater and intrarater reliability.

BACKGROUND AND PURPOSE: Navicular drop (ND) measurement may be a valuable examination technique for patients with rheumatoid arthritis (RA). However, no data exist on reliability for this technique in patients with RA. The purposes of this study were: (1) to determine interrater and intrarater reliability of ND measurements in people with RA, (2) to compare ND values of people with RA with published normative data, and (3) to investigate ND measurement error associated with the use of skin markings. SUBJECTS: Ten women (20 feet) with RA consented to participate. METHODS: Patients completed demographic and function questionnaires. Navicular height (NH) measurements were taken by 2 physical therapists and 1 physical therapist student, following four 1-hour training sessions, using standardized methods and a digital height gauge. Four different NH measurements were taken 3 times on each foot by each of the 3 examiners during a morning session and then repeated during an afternoon session on the same day. Navicular drop values were calculated, including ND1 (as reported in the literature), ND2 (compensating for skin error), and ND3 (single-limb stance). Intraclass correlation coefficients (ICCs) and standard errors of measurement (SEMs) were used to establish reliability. RESULTS: Means (+/-SD) for each ND measure for sessions 1 and 2, respectively, were as follows: ND1=8.36+/-5.29 mm and 8.29+/-5.24 mm, ND2=9.95+/-5.44 mm and 9.57+/-5.37 mm. The ICCs (2,1 and 2,k, respectively) for all interrater measurements ranged from .67 to .92 (SEM=2.0-3.3 mm) and from .85 to .97 (SEM=1.1-2.0 mm). The ICCs (2,1 and 2,k, respectively) for intrarater measurements ranged from .73 to .95 (SEM=1.3-2.8 mm) and from .90 to .98 (SEM=0.7-1.6 mm). Paired t tests showed the means of ND1 and ND2 for each examiner and for both sessions were significantly different. DISCUSSION AND CONCLUSION: The results suggest that ND measurements for people with RA can be taken reliably by clinicians with varied experience. The ND values for our subjects were slightly greater than reported normal values of 6 to 8 mm. Error associated with skin markings was statistically significant for all sessions and examiners.

Evidence-based rating of upper-extremity motor function tests used for people following a stroke.

INTRODUCTION: Tests of upper-extremity motor function used for people following a stroke have been described, but reliability and validity (psychometric properties) of measurements obtained with these tests have not been consistently established. This investigation was performed: (1) to review literature relative to upper-extremity motor function testing during rehabilitation following a stroke, (2) to develop selection criteria for identifying these tests in the literature, and (3) to rate the tests relative to their psychometric properties. METHOD: Literature searches were done using 2 databases. Reports of 4 psychometric properties were sought: interrater reliability, test-retest reliability, convergent validity or concurrent validity, and predictive validity. RESULTS: Nine tests met the inclusion criteria of having psychometric properties reported in the literature. No test had evidence for all 4 psychometric properties. Only the Nine-Hole Peg Test was supported by 3 out of 4 properties. Most tests had 2 properties supported. Concurrent validity or convergent validity was most frequently described; test-retest reliability was least frequently described. CONCLUSIONS: More complete psychometric support is needed for upper-extremity motor function tests applied following a stroke. The absence of psychometric support, however, does not mean that a test has no value. Clinicians are cautioned not to generalize psychometric evidence.