Reliability and Concurrent Validity of the Motor Evaluation Scale for Upper Extremity in People With Chronic Stroke

To evaluate the reliability and concurrent validity of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and establish a cut-off score distinguishing people with chronic stroke from healthy older adults.

This cross-sectional study included 64 individuals with chronic stroke and 31 healthy older adults at a university-based rehabilitation center. Assessments included MESUPES, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), muscle strength and stiffness, wrist range of motion, Action Research Arm Test (ARAT), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and Oxford Participation and Activities Questionnaire.

MESUPES total scores demonstrated excellent inter-rater (intraclass correlation coefficient [ICC]=0.976; 95% confidence interval [CI]: 0.960-0.985) and test-retest reliability (ICC=0.965; 95% CI: 0.943-0.978). A ceiling effect, but no floor effect, was observed; sensitivity analyses confirmed that excellent reliability was not solely attributable to ceiling effects. MESUPES scores correlated with FMA-UE (r=0.872-0.922), ARAT (r=0.821-0.885), affected elbow strength (r=0.585-0.661), wrist range of motion (dorsal-palmar: r=0.727-0.751; ulnar-radial: r=0.750-0.817), handgrip strength (r=0.674-0.783), and QuickDASH (r=-0.433 to -0.521; all p<0.001). A cut-off score of 57.5 differentiated participants with stroke from healthy older adults, with 93.5% sensitivity and 82.8% specificity.

MESUPES demonstrated excellent reliability and concurrent validity for assessing upper-limb movement quality in chronic stroke. The cut-off score of 57.5 discriminated between participants with stroke and healthy older adults. Associations with established impairment- and activity-level measures support its use as a complementary assessment in chronic stroke rehabilitation.