title: A new hand assessment instrument for severely affected stroke patients.
abstract: BACKGROUND
  Standard assessment instruments cannot differentiate patients with minimal residual hand function after stroke. As a result, changes in motor recovery are difficult to document using currently-available tests. In a controlled study with chronic stroke patients without residual finger extension, a new hand function test has been developed. This instrument, called Broetz Hand Test (BzH), allows to assess small variations in hand function in severely paralyzed stoke patients. The instrument is easy to use, and was developed using principles of motor learning and behavioral assessment.
  
  
  METHODS
  The instrument consists of seven daily life-oriented tasks, each of which asks for movement of the paralyzed hand. BzH of 20 patients after stroke was evaluated before and after a behavioral physiotherapy treatment. Sensitivity, inter-observer reliability, test-retest reliability and construct validity was calculated.
  
  
  RESULTS
  Two-tailed paired-samples t-test before and after treatment demonstrated sufficient sensitivity. Mean agreement between the raters resulted in an excellent interrater-reliability. Test-retest reliability between the pre- and post-treatment scores was 0.9. The correlation between BzH and standard test scores was statistically significant and demonstrated sufficient validity.
  
  
  CONCLUSIONS
  The BzH is a valid and reliable tool to assess changes in hand function in severely paralyzed patients after stroke.
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany.
authors: Doris
authors: D
authors: Broetz
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany.
authors: Nicholas A
authors: NA
authors: Del Grosso
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany.
authors: Massimiliano
authors: M
authors: Rea
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany Health Technologies Department, TECNALIA, San Sebastian, Spain.
authors: Ander
authors: A
authors: Ramos-Murguialday
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany Department of Psychiatry and Psychotherapy, University of Tuebingen, Tuebingen, Germany.
authors: Surjo R
authors: SR
authors: Soekadar
authors: Institute of Medical Psychology and Behavioral Neurobiology, MEG Center, University of Tuebingen, Tuebingen, Germany Ospedale San Camillo, Istituto di Ricovero e Cura a Curattere Scientifico, IRCCS, Venezia, Italy.
authors: Niels
authors: N
authors: Birbaumer
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology*; D009460:Neurologic Examination / Q000379:methods; D015588:Observer Variation; D026741:Physical Therapy Modalities; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D013647:Task Performance and Analysis
keywords: Stroke; assessment; hand function; physiotherapy; rehabilitation