[Inter-rater agreement of a functional analytical measure of the upper limb]

The determination and the follow-up of a patient having an upper limb lesion need a functional assessment instrument. This study examined the inter-rater agreements of the "400 points Measure", between two occupational therapists and a physiotherapist. One occupational therapist only had already used this instrument. The others raters received preliminary training with an audio-visual projection. The scale included four tests with 57 activities: (E1) Functions of the hand and fingers, (E2) Prehension strengths, (E3) Handling and displacement of things, and (E4) Functions with both hands. The study population consisted of 85 patients of a rehabilitation centre. Inter-rater agreements were quite good for E1 and E3, but they were not as good for E4, that included several functions of both limbs. For E1, the physiotherapist rated slightly but significantly different from the other raters. For E3 and E4, the occupational therapist having used the scale, rated lower than the other raters; but the difference was small. For E1, the physiotherapist rated higher than the two occupational therapists for the elderly. A discussion with the raters and a new trying showed that the differences will be small when the above training is completed by a short training about the standard gestures and the detection of the abnormalities.