Evaluating the impact of stroke rehabilitation requires the use of reliable, valid, and objective outcome measures. Despite consensus among nationally published guidelines recommending the use of valid and reliable assessment tools, the scientific community lacks direction regarding what outcome measures should be selected for particular evaluative needs. One measure that appears to have general acceptance and embraced by many neurorehabilitation specialists is the Action Research Arm Test (ARAT).
The Action Research Arm Test (ARAT) is a commonly used standardized and reliable measure for stroke rehabilitation. The ARAT is a proven standardized evaluative measure to assess specific changes in upper limb function among individuals who sustained cortical damage resulting in hemiplegia. The reliable and valid test typically takes less than 10 minutes to complete.
That ARAT consists of 19 items that are grouped into four subtests: grasp, grip, pinch, and gross movement. All items are rated on a 4-point ordinal scale ranging from 0 (no movement possible) to 3 (normal performance of the task). The subtest scores vary according to the number of items performed in each subtest. The total score on the ARAT ranges from 0-57, with a higher score indicating better performance.
Watch the below video to learn more about the ARAT.
Adams, R.J., Meador, K.J., Sethi, K.D., Grotta, J.C., & Thomson, D.S. (1986). Graded neurologic scale for the use in acute hemispheric stroke treatment protocols. Stroke, 18, 665-669.
Ashworth, B. (1964). Preliminary trial of carisoprodol in multiple sclerosis. Practitioner, 192, 540-542.
Brott, T. G., Adams, H. P., Olinger, C. P., Marler, J. R., Barsan, W. G., Biller, J., Spilker, J., Holleran, R., Eberle, R., Hertzberg, V., Rorick, M., Moomaw, C. J., & Walker, M. (1989). Measurements of acute cerebral infarction: a clinical examination scale. Stroke, 20, 864 -70.
Carroll, D. (1965). A quantitative test of upper extremity function. Journal of Chronic Disability, 18, 479-91.
Carr, J.H., Shepherd, R.B., Nordholm, L., & Lynne, D. (1985). Investigation of a new motor assessment scale for stroke patients. Physical Therapy, 65, 175- 180.
Collin, C., Wade, D.T., Davies, S., & Horne, V. (1988). The Barthel ADL Index: a reliability study. International Disability Study, 10, 61-63.
Demeurisse, G., Demol, O., & Robaye, E. (1980). Motor evaluation in vascular hemiplegia. European Neurology, 19(6), 382-389.
De Weerdt, W.J.G., & Harrison, M.A. (1985). Measuring recovery of arm hand function in stroke patients: a comparison of the Brunnstrom-Fugl-Meyer test and the Action Research Arm Test. Physiotherapy Canada, 37, 65-70.
Finch, E., Brooks, D., Stratford,P.W, & Mayo, N.E. (2002). Physical Outcome Measures: A guide to enhance physical outcome measures. Ontario, Canada: Lippincott, Williams, & Wilkins.
Fugl-Meyer, A.R., Jääskö, L., Leyman, I., Olsson, S., & Steglind, S. (1975). The post-stroke hemiplegic patient 1. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine, 7, 13-31.
Gowland, C., Van-Hullenaar, S., Torresin, W., et al., (1995). Chedoke-McMaster Stroke Assessment: development, validation, and administration manual.Hamilton, (ON), Canada: School of Rehabilitation Science, McMaster University
Heller, A., Wade, D.T., Wood, V.A., Sunderland, A., Hewer, R., & Ward, E. (1987). Arm function after stroke: measurement and recovery over the first three months. Journal of Neurology, Neurosurgery & Psychiatry, 50(6), 714-719.
Hsieh, C.L., Hsueh, I.P, Chiang, F., & Lin, P. (1998). Inter-rater reliability and validity of the action research arm test in stroke patients. Age and Ageing, 27, 107-113.
Hsueh, I.P, Lee, M.M., & Hsieh, C.L. (2002a). The action research arm test: Is it necessary for patients being tested to sit at a standardized table? Clinical Rehabilitation, 16, 382-388.
Hsueh, I.P. & Hsieh, C.L. (2002b). Responsiveness of two upper extremity function instruments for stroke inpatients receiving rehabilitation. Clinical Rehabilitation, 16, 617-624.
Jacobson-Sollerman, X & Sperling, Y. (1977). Grip function of the healthy hand in a standardized hand function test. A study of the Rancho Los Amigos test. Scandinavian Journal of Rehabilitation Medicine, 9(3), 123-129.
Keith, R.A, Granger, C.V., Hamilton, B.B., & Sherwin, F.S. (1987). The Functional Independence Measure: a new tool for rehabilitation. In: Eisenberg, M.G. & Grzesiak, R.C. (Ed.), Advances in clinical rehabilitation(pp. 6-18). New York: Springer Publishing Company.
Kellor, M., Frost, J., Silberberg, N., Iversen, I., & Cummings R. (1971). Hand strength and dexterity. American Journal of Occupational Therapy, 25, 77-83.
Lang, C.E., Wagner, J.M, Dromerick, A.W., & Edwards, D.F. (2006). Measurement of upper extremity function early after stroke: properties of the action research arm test. Archives Physical Medicine and Rehabilitation, 87, 1605-1610.
Lin, K-C., Chuang, L-L., Wu, C-Y., Hseih, Y-W. & Chang, W-Y. (2010). Responsiveness and validity of three dexterous function measures in stroke rehabilitation. Journal of Rehabilitation Research and Development, 47(6), 563-572.
Lindmark, B. & Hamrin, E. (1988). Evaluation of function capacity after stroke as a basis for active intervention: Presentation of a modified chart for motor capacity assessment and its reliability. Scandinavian Journal of Rehabilitation Medicine, 20, 103-109.
Lyle, R.C. (1981). A performance test for assessment of upper limb function in physical rehabilitation treatment and research. International Journal of Rehabilitation and Research, 4, 483-492.
Mathiowetz, V., Volland, G., Kashman, N., & Weber, K. (1985a). Adult norms for the box and block test of manual dexterity. American Journal of Occupational Therapy, 39, 386-391.
Mathiowetz, V., Weber, K., Kashman, N., & Volland, G. (1985b). Adult norms for the nine hole peg test of finger dexterity. Occupational Therapy Journal of Research, 5, 24 -33.
Nijland, R., van Wegen, E., Verbunt, J, van Wijk, R., van Kordelaar, J. & Kwakkel, G. (2010) A comparison of two validated tests for upper limb function after stroke: The Wolf Motor Function Test and the Action Research Arm Test. Journal of Rehabilitation Medicine, 42, 694-696.
Platz, T., Pinkowski, C., van Wijck, F., Kim, I.H., di Bella, P., & Johnson, G. (2005). Reliability and validity of arm function assessment with standardized guidelines for the Fugl-Meyer Test, Action Research Arm Test and Box and Block Test: a multicentre study. Clinical Rehabilitation, 19(4), 404-411.
Rabadi, M.H. & Rabadi, F.M. (2006). Comparison of the action research arm test and the Fugl-Meyer Assessment as measures of upper-extremity motor weakness after stroke. Archives of Physical of Medicine Rehabilitation, 87, 962-966.
van der Lee, J.H, Beckerman, H., Lankhorst, G.J., Bouter, L.M. (2001a). The responsiveness of the Action Research Arm Test and the Fugl-Meyer Assessment Scale in chronic stroke patients. Journal of Rehabilitation Medicine, 33, 110-113.
van der Lee, J.H, Groot, V., Beckerman, H., Wagenaar, R.C., Lankhorst, G.J., Bouter, L.M. (2001b). The intra-rater and interrater reliability of the action research arm test: a practical test of upper extremity function in patients with stroke. Archives of Physical of Medicine Rehabilitation, 82, 14-19.
van der Lee, J.H, Roorda, L.D., & Lankhorst, G.J. (2002). Improving the Action Research Arm Test: a unidimensional hierarchical scale. Clinical Rehabilitation, 16, 646-653.
Yozbatiran, N., Der-Yerghiaian, L., & Cramer, S.C. (2008). A standardized approach to performing the action research arm test. Neurorehabilitation & Neural Repair, 22(1), 78-90.