title: Can quality of movement be measured? Rasch analysis and inter-rater reliability of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES).
abstract: OBJECTIVE
  Clinical scales evaluating arm function after stroke are weak at detecting quality of movement. Therefore a new scale, the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES), was developed, comprising 22 items pertaining to arm and hand performance. The scale was investigated for validity and unidimensionality using the Rasch measurement model, and for inter-rater reliability.
  
  
  METHODS
  Twelve hospitals and rehabilitation centres in Belgium, Germany and Switzerland.
  
  
  METHODS
  There were 396 patients (average age 63.38+/-12.89 years) in the Rasch study and 56 patients (average age 65.68+/-12.75 years) in the reliability study.
  
  
  METHODS
  The scale was examined on its fit to the Rasch model, thereby evaluating the scale's unidimensionality and validity. Differential item functioning was performed to test the stability of item hierarchy on several variables. Inter-rater reliability was examined with kappa values, weighted percentage agreement and intraclass correlation coefficients (ICC).
  
  
  RESULTS
  Based on Rasch analysis, five items were removed. The MESUPES was divided in two tests: the MESUPES-arm test (8 items) and MESUPES-hand test (9 items). Both scales fitted the Rasch model. All items were stable among the subgroups of the sample. ICCs were 0.95 (95% confidence interval (CI) 0.91 -0.97) and 0.97 (95% CI 0.95-0.98) for the total score on arm and hand test respectively. The scale was also reliable at item level (weighted kappa 0.62 -0.79, weighted percentage agreement 85.71 -98.21).
  
  
  CONCLUSIONS
  The MESUPES-arm and MESUPES-hand meet the statistical properties of reliability, validity and unidimensionality. Both tests provide a useful clinical and research tool to qualitatively evaluate arm and hand function during recovery after stroke.
authors.affiliation: Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, KU Leuven, Belgium. Ann.VandeWinckel@faber.kuleuven.be
authors.forename: Ann
authors.initials: A
authors.lastname: Van de Winckel
authors.forename: Hilde
authors.initials: H
authors.lastname: Feys
authors.forename: Suzan
authors.initials: S
authors.lastname: van der Knaap
authors.forename: Ruth
authors.initials: R
authors.lastname: Messerli
authors.forename: Fabio
authors.initials: F
authors.lastname: Baronti
authors.forename: Ruth
authors.initials: R
authors.lastname: Lehmann
authors.forename: Bart
authors.initials: B
authors.lastname: Van Hemelrijk
authors.forename: Franca
authors.initials: F
authors.lastname: Pantè
authors.forename: Carlo
authors.initials: C
authors.lastname: Perfetti
authors.forename: Willy
authors.initials: W
authors.lastname: De Weerdt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D017063:Outcome Assessment, Health Care; D025341:Principal Component Analysis; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000503:physiopathology*