Background: Spontaneous use of the upper extremities on the affected side of patients with stroke is a meaningful indicator of recovery and may vary by the age or dominant hand of patients. No prior study has reported changes in actual amount of use test (AAUT) and motor activity log (MAL)-28 according to age and handedness in healthy adults, and AAUT inter-rater reliability for assessment of healthy adults. Objects: This study aimed to (1) research the differences in AAUT and MAL-28 according to age and handedness in healthy adults, and (2) determine the inter-rater reliability of the AAUT. Methods: Seventy healthy adults participated in this study. The MAL-28 was assessed by dividing 61 subjects into young right-handed (n1=20), young left-handed (n2=21), and older right-handed (n3=20) groups. The AAUT was assessed by dividing 63 subjects into young right-handed (n1=25), young left-handed (n2=18), and older right-handed (n3=20) groups. Student’s t-test and the Wilcoxon signedrank test were used for statistical analysis. Results: The Amount of Use (AOU) scale values for each group showed no significant differences between age groups and handedness groups in the MAL-28 (p>.05). The AAUT AOU scale value showed significant differences regarding dominant handedness in the AAUT (p<.05), but no significant differences according to age (p>.05). (2) Inter-rater reliability of the AAUT was excellent, except few items (item 9, 11, and 12). Conclusion: Although both the MAL-28 and the AAUT measured how much participants used their dominant arms in healthy subjects, the AAUT only showed significantly higher dominant arm use in left hander than the right hander. In addition, the inter-rater reliability of the AAUT was excellent. Current results can be utilized as a basic information when clinicians develop rehabilitation strategies, and AAUT was shown to be a reliable evaluation tool for measurement of upper extremity use in Korean adults, based on the reliability demonstrated by this study.

목적 : 한글판 수정바델지수 체크리스트를 고안하고 기존 한글판 수정바델지수와 신뢰도를 비교 평가하기 위함이다. 연구방법 : 연구대상은 뇌병변 환자 30명을 대상으로 하였다. 한글판 수정바델지수 체크리스트(이하 K-MBI 체크리스트)는 기존의 한글판 수정바델지수(기존 K-MBI)와 수정바델지수(MBI) 원본을 참고하여 각 항목별 평가 내용을 세분화 및 체크리스트화 하였다. 30명의 환자를 대상으로 K-MBI 체크리스트를 사용하는 그룹과 기존 KMBI를 사용하 는 그룹으로 나누어 각 그룹에 2명의 치료사를 배정하였다. 결과분석은 평가자간 신뢰도를 알아보기 위해 총점수준에서 급간내상관계수를 구하였으며, 세부항목 수준에서 카파검정을 시행하였다. 결과 : 총점수준에서의 신뢰도는 K-MBI 체크리스트(ICC= .981)와 기존 K-MBI(ICC= .973)를 사용한 두 그룹 모두에서 매우 높은 검사자간 신뢰도를 보였다(p<.001). 세부항목별 일치도에서는 K-MBI 체크리스트를 사용한 그룹과 기존 K-MBI의 경우 모두 4개 항목에서 탁월한 일치도를 보였다. Mean K값은 K-MBI 체크리스트(.725)가 K-MBI(.699) 보다 높게 나타났다. 결론 : K-MBI 체크리스트와 기존의 K-MBI 모두 총점수준에서 높은 수준의 평가자간 신뢰도를 보였다. 세부항목수준에서 역시 두 그룹 모두 전 항목에서 상당한 수준 이상의 신뢰도를 확보하였으나, 항목 간에는 다소 차이가 있었다.

The aim of this study was performed to determine the inter-rater reliability of the Stroke Rehabilitation Assessment of Movement (STREAM) translated in Korean. This was a new clinical measurement tool for evaluating the recovery of voluntary movement and basic mobility following stroke. A direct-observation reliability study was conducted on 20 patients who had strokes and were in a rehabilitation setting. Subjects were assessed by two physical therapists. The reliability of the STREAM scores was demonstrated by weighted kappa statistics for inter-rater agreement on scores for individual items ranged from .83 to 1.0, intraclass correlation coefficients for total score was .99, and for subscale scores was ranged from .96 to .99. The internal consistency of the STREAM scores was demonstrated by Cronbach alphas of greater than .99 on the subscales and overall. These high levels of reliability support the use of the STREAM translated in Korean instrument for the measurement of motor recovery following stroke.

This study was performed to determine the inter-rater reliability of the Chedoke-McMaster Stroke Assessment translated in Korean. This measures the physical impairments and disabilities that impact on the lives of individuals with stroke. The purposes of this measure were 1) to stage motor recovery to classify individuals in terms of clinical characteristics, 2) to predict rehabilitation outcomes, and 3) to measure clinically important change in physical function. Twenty-two subjects from physical therapy unit were assessed by two physical therapists. The ratings were compared by Spearman's rank correlation The correlation between two raters ranged from 0.85 to 0.98. Inter-rater reliability coefficient for total scores ranged from 0.95 to 0.97. This study confirms that the Chedoke-McMaster Stroke Assessment yields reliable results.

This study was performed to determine the inter-rater reliability of manual tests of elbow, knee flexor, and ankle dorsiflexor muscle spasticity graded on the Modified Ashworth Scale. Two raters each independently graded the spasticity of 32 patients with intracranial lesions after moving the paretic limb passively through the available range of motion. The patients were asked to simultaneously squeeze therapeutic putty with their non-paretic hand for reinforcement. The ratings were compared by the Wilcoxon matched pairs signed-rank test and by the Kendall's coefficient of rank(tau) correlation. There was singificant correlation between two raters for spasticity at the elbow, knee flexor, and ankle dorsiflexor. The correlations of the two raters ranged from .6746 to .9308. The highest correlation was for the elbow with reinforcement and the lowest was for the knee without reinforcement. Poorer correlation was evident in the knee joint. The positive results of this study encourage the continued use of manual tests of muscle spasticity, using the Modified Ashworth Scale.