Action Research Arm Test (ARAT)

 
Action Research Arm Test Evaluation Summary

  What does the tool measure? The ARAT measures specific changes in limb function among individuals who sustained cortical damage resulting in hemiplegia.
  What types of clients can the tool be used for? The ARAT can be used with, but is not limited to clients with stroke.
  Is this a screening or assessment tool? Assessment
Time to administer An average of 7 to 10 minutes.
  Versions There are no alternative versions.
Other Languages There are no official translations.
 Measurement Properties
  Reliability

– One study examined the internal consistency of the ARAT and reported excellent internal consistency using Cronbach’s alpha.
– Three studies have examined the test-retest reliability of the ARAT. All reported excellent test-retest reliability using ICCs.
– Four studies have examined the intra-rater reliability of the ARAT and reported excellent intra-rater reliability using Spearman rho correlation, intraclass correlation coefficients (ICC) and weighted kappa.
– Seven studies examined the inter-rater reliability of the ARAT and reported excellent inter-rater reliability using Spearman rho correlation, Intra ICC and weighted kappa.

  Validity

Criterion
Predictive Validity:
No studies have examined the predictive validity of the ARAT.

Concurrent:
– One study has examined the concurrent validity of the ARAT and reported adequate to excellent correlations with the Box and Block Test (BBT) and the Nine-Hole Peg Test (NHPT) at pre and post-treatment.

Construct
Convergent validity:
– Seven studies examined convergent validity of the ARAT and reported excellent correlations between the ARAT and the Brunnstrom-Fugl-Meyer test; the upper extremity subscale of the Motor Assessment scale; the Motricity Index; the upper extremity movement of Modified Motor Assessment Chart; the BTT; the motor function subscore of the Fugl-Meyer test; the Hemispheric Stroke Scale; upper extremity strength and grasp speed. Adequate correlations were reported between the ARAT and the passive joint motion/joint pain of the Fugl-Meyer test, the Functional Independence Measure and spasticity. Poor correlations were reported between the ARAT and the sensation score of the Fugl-Meyer test, the Ashworth scale, the Modified Barthel Index, the National Institutes of Health Stroke Scale, the light touch sensation and pain.

  Floor/Ceiling Effects

– One study examined the floor/ceiling effects of the ARAT in clients with acute stroke and reported that at earlier phases of the stroke, floor effects were poor. At discharge from the acute rehabilitation ward, ceiling effects on the ARAT were adequate.
– One study examined the floor/ceiling effects of the ARAT in stroke clients with mild to moderate hemiparesis and reported adequate floor and ceiling effects.

  Sensitivity/ Specificity No studies have examined the specificity of the ARAT.
  Does the tool detect change in patients? – Six studies have examined the responsiveness of the ARAT and reported that the ARAT has a moderate to large Standardized Response Mean, moderate to large effect size and large responsiveness ratio, therefore, is able to detect change in clients with stroke.
  Acceptability When administering the ARAT to clients with upper extremity amputations attention is required when scoring (i.e. – a score of 0 is given).
Feasibility The administration of the ARAT is quick and simple, but requires standardized equipment.
How to obtain the tool? Information on the ARAT can be obtained in the study by Lyle (1981), Hsieh et al. (1998), van der Lee et al. (2002), Rabadi & Rabadi (2006), and Yozbatiran et al. (2008) and at the website: http://www.aratest.eu/Index_english.htm Standardized equipment can be purchased from the following website: http://www.aratest.eu/ or from http://www.saliarehab.com/.