Development and initial psychometric properties of the timed upper limb assessment in older adults with Parkinson's

Upper limb dysfunction is common in people with Parkinson's. This study aimed to pilot and establish the initial psychometric properties of the timed upper limb assessment (TULA), a 10-item timed functional upper limb assessment tool.

A prospective observational study was conducted with 381 participants (202 with Parkinson's, 179 controls). The TULA was administered to both groups, with inter-rater reliability assessed in a subset (n = 47). Principal component analysis examined structural validity, while convergent validity was explored through correlations with cognitive and motor assessments.

The TULA demonstrated high internal consistency (Cronbach's α = 0.81 for Parkinson's group) and high inter-rater reliability (intraclass correlation coefficient (ICC) > 0.9). People with Parkinson's took significantly longer to complete all items (mean (SD) 22.2 ± 7.5) compared to controls (16.8 ± 3.7, p < 0.001). The tool showed moderate correlation with the timed up and go test (r = 0.56, p < 0.001), a significant low correlation with the Hoehn and Yahr Scale (r = 0.44, p ⩽ 0.001) and a significant low correlation with both the Montreal Cognitive Assessment (r = -0.37, p ⩽ 0.001) and the Mini Mental Status Examination (r = -0.31, p ⩽ 0.001).

This study provides an alternative functional upper limb assessment tool for people with Parkinson's attending occupational therapy. Initial data have been provided to support the reliability and validity of the TULA.