Assessment Overview

Purpose: Quality upper limb functionality through observation.

Summary: There are 4 categories within the exam including grasp, grip, pinch, and gross arm movement and a total of 19 items measured. The patient is rated on a scale from 0-3 on each item with a maximum score of 57 points. According to Lyle’s decision rules, if a patient is able to score a 3 on the first item in a category they are given a maximum score for the remaining items without need for examination.

Equipment: Specialized kit ($645)

ICF Category: Activity

Assessment Handout

Assessment Psychometrics

There are no recommendations for use of the Action Arm Research Test (ARAT) with patients after a brain injury who are completely independent, mildly dependent, moderately dependent, or severely dependent. There have not been sufficient studies to recommend the use of the ARAT in acute care or inpatient rehabilitation settings. However the ARAT is recommended for use in skilled nursing facilities, outpatient rehabilitation, and home health settings. This measure should be taught to students and is appropriate for use in research. Below are psychometrics from a mixed diagnosis population sample:

• Construct Validity: Strongly correlated with the Fugl-Meyer motor exam (ρ=0.925) and the Box and Block Test (ρ=0.951)

• Interrater Reliability:

  • Excellent for:

    • Total score (ICC=0.998)

    • Grasp (ICC=0.997)

    • Grip (ICC=0.964)

    • Gross movement (ICC=0.984)

    • Pinch (ICC=0.999)

• Test-retest:

  • Excellent for:

    • Total score (ICC=0.965)

    • Grasp (ICC=0.949)

    • Grip (ICC=0.947)

    • Gross movement (ICC=0.976)

  • Adequate for:

    • Pinch (ICC=0.894)