Reliability and Validity of a New Diagnostic Device for Quantifying Hemiparetic Arm Impairments: An Exploratory Study

To assess test-retest reliability and validity of a new diagnostic device, the Shoulder Elbow Perturbator, to quantify muscle weakness, abnormal synergy, (muscle activity-related) spasticity, and changes in viscoelastic joint properties of the elbow.

Stroke patients, adults with cerebral palsy and healthy controls.

Test-retest reliability was evaluated using intra-class correlations (ICC) and assessment of measurement error. The device's validity was evaluated by demonstrating differences between patients and healthy controls, and correlations of spasticity and abnormal synergy outcomes using the clinical Modified Tardieu Scale, the Fugl-Meyer Assessment, and the Test of Arm Selective Control.

Reliability was excellent, with an ICC > 0.75 for synergy and ICCs > 0.90 for all other impairments, with relatively small measurement errors. Validity was confirmed by group differences between patients and healthy controls for muscle weakness, spasticity, and viscoelastic joint properties, but not for abnormal synergy. Correlation analysis with clinical scales confirmed validity for spasticity, while, for synergy, correlations were found in the patients with stroke, but not those with cerebral palsy.

This new diagnostic device is a reliable and valid instrument to assess multiple upper limb impairments in patients with neurological conditions, supporting its use in clinical practice. Further studies are needed to confirm these findings.