Development and validation of a scale for rating motor compensations used for reaching in patients with hemiparesis: the reaching performance scale.

BACKGROUND AND PURPOSE Recent movement analysis studies have described compensatory movement strategies used by people with hemiparesis secondary to stroke during reaching and grasping tasks. The purpose of this article is to describe the development of a new scale--the Reaching Performance Scale (RPS)--for assessing compensatory movements for upper-extremity reaching in people with hemiparesis secondary to stroke. SUBJECTS Twenty-eight individuals with hemiparesis, with a mean age of 54.9 years (SD=18.6), participated. METHODS The study design involved scale development with expert panels and criterion standards for validity. Participants were evaluated on the new scale as well as other clinical tests for validity. They were videotaped while performing reaching and grasping movements. RESULTS The RPS scores correlated with measurements of grip force and Chedoke-McMaster Stroke Assessment and Upper Extremity Performance Test for the Elderly (TEMPA) scores. The RPS discriminated patients with different impairment levels according to the Chedoke-McMaster Stroke Assessment. Preliminary intrarater and interrater reliability coefficients were acceptable for the whole scale. Mean kappa values on individual scale components for 3 raters represented a mean of 67% (SD=13.5%) agreement. DISCUSSION AND CONCLUSION Although the RPS shows some types of validity, more rigorous tests of reliability are needed for meaningful conclusions. This study is a first step in validating the scale to assess efficacy of intervention for motor recovery of the arm.