Development and Validation of a Bedside Scale for Assessing Upper Limb Function Following Stroke: A Methodological Study

Abstract

Objective : This study aimed to develop and concurrently validate a simple, resource-efficient, and time-efficient bedside tool based on day-to-day movement tasks for evaluating upper limb function in stroke survivors. Methods: The study’s qualitative and cross-sectional component was conducted in 2 stages. At the initial stage, a relevant literature review was carried out to conceptualize and define the theoretical framework of day-to-day movement tasks, in evaluating upper limb function. Subsequently, an initial item pool of 18 upper limb and hand movements was developed. A Delphi method was employed to verify content validity of the initial 18-item scale using an expert consensus panel of 6 subject matter experts (three neurologists, two physiotherapists, and 1 occupation therapist). At the first round, 4 items were excluded using expert panel consensus method. During the second round of the content validation phase, the remaining 14-item scale was revised and refined to a final 12-item scale by the expert panel using a 5-point Likert rating scale. A score of 2 or below by at least two experts on a 5-point Likert scale was used as the criterion to modify or remove the components. During the second stage, the final 12-item bedside upper limb evaluation tool (BUFET) scale underwent concurrent validation using purposive sampling of 25 stroke survivors. Concurrent validity was assessed by correlating the BUFET score with Wolf Motor Function (WMT) scores using Spearman's correlation coefficient and internal consistency was evaluated through Cronbach’s alpha. Results: Concurrent validity and internal consistency of the scale were supported by a high correlation coefficient (r = 0.937; p<0.001) with WMFT and high Cronbach’s alpha (0.948). Conclusions: The newly developed BUFET was found to be a valid and reliable bedside tool in the evaluation of upper limb functions and can be administered in a resource and time-efficient manner.