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Rehab Measures: Chedoke Arm and Hand Activity Inventory - 7

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Link to Chedoke Arm and Hand Activity Inventory - 7 

Title of Assessment

Chedoke Arm and Hand Activity Inventory - 7 

Acronym

CAHAI - 7

Instrument Reviewer(s)

Initially reviewed by Dorian Rose and the Stroke Edge Taskforce of the Neurolgy Section of the APTA

Summary Date

4/6/2016 

Purpose

The purpose of this measure is to evaluate the functional ability of the paretic arm and hand to perform tasks.

Description

The CAHAI is a performance test using functional items. It is not designed to measure the client’s ability to complete the task using only their unaffected hand, but rather to encourage bilateral function.

This test consists of 13 functional tasks to complete (open jar of coffee, call 911, draw a line with a ruler, put toothpaste on toothbrush, cut medium consistency putty, pour a glass of water, wring out washcloth, clean pair of eyeglasses, zip up a zipper, do up 5 buttons, dry back with towel, place container on table, carry bag upstairs).

Area of Assessment

Activities of Daily Living; Upper Extremity Function 

Body Part

Upper Extremity 

ICF Domain

Activity 

Domain

ADL; Motor 

Assessment Type

Performance Measure 

Length of Test

06 to 30 Minutes 

Time to Administer

30 mintues.

Number of Items

13 

Equipment Required

  • Jar of coffee
  • Phone
  • Ruler and pen
  • Toothpaste and toothbrush
  • Knife
  • Fork
  • Putty
  • Glass of water
  • Wet washcloth
  • Eyeglasses
  • Jacket and zipper
  • Shirt with 5 buttons
  • Towel
  • Rubbermaid 38 liter container (50x37x27cm) with 10 lb. weight
  • Plastic gorcery bag with 4 lb. weight

Training Required

Read the administration and scoring manual

Type of training required

reading an article/manual 

Cost

Free 

Actual Cost

$0.00

Age Range

 

Administration Mode

Paper/Pencil 

Diagnosis

Movement Disorders 

Populations Tested

Upper Extremity Paralysis
Stroke (inpatient and outpatient)

Standard Error of Measurement (SEM)

Not Established.

Minimal Detectable Change (MDC)

Upper Extremity Paralysis
 
(Barreca et al, 2005)
  • MDC (90) = 6.3 points

Minimally Clinically Important Difference (MCID)

Not Established.

Cut-Off Scores

Not Established.

Normative Data

Not Established.

Test-retest Reliability

Upper Extremity Paralysis:
 
("Psychometric properties: Reliability")
  • Excellent reliability (ICC = 0.96)

Interrater/Intrarater Reliability

Stroke: (Schuster, 2010; n = 23 patients (Mean age 69.4, SD 12.9: 6 females; Mean time post-stroke: 1.5y (2.5y))

  • Excellent reliability (ICC = ranges from 0.96-0.99 for CAHAI-G 13, 9, 8, 7)

Upper Extremity Paralysis:

 
(Barreca et al, 2005)
  • Excellent reliability (ICC = 0.98)

Internal Consistency

Upper Extremity Paralysis:
 
("Psychometric properties: Reliability")
  • Excellent reliability (ICC = 0.95)

Stroke:

  • Excellent reliability (ICC = 0.967)

Criterion Validity (Predictive/Concurrent)

Not Established.

Construct Validity (Convergent/Discriminant)

Not Established.

Content Validity

Not Established.

Face Validity

Not Established.

Floor/Ceiling Effects

Not Established.

Responsiveness

Not Established.

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations for use based on acuity level of the patient:

 

Acute

(CVA < 2 months post)

(SCI < 1 month post)

(Vestibular < 6 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

NR

NR

NR

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

NR

NR

NR

NR

NR

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

StrokEDGE

No

Yes

No

Not reported

Considerations

  • Client should have some active movemtn capacity in the involved arm
  • All three shortened versions of the CAHAI-13 demonstrated strong psychometric properties and can be used as a functional measure for assessment for UE function (especially with limited time and resources). The CAHAI-7 maintained the highest level of longitudinal validity and cross-sectional validity.
  • CAHAI is inexpensive and transportable compared to the ARAT. Whereas the ARAT bilaterally examines upper limb function, the CAHAI takes a bilateral approach to analyzing basic functional tasks.

Bibliography

Barreca, S., Gowland, C. K., et al. (2004). "Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection." Top Stroke Rehabil 11(4): 31-42. Find it on PubMed

Barreca, S. R., Stratford, P. W., et al. (2005). "Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke." Arch Phys Med Rehabil 86(8): 1616-1622. Find it on PubMed 

Schuster, C., Hahn, S. & Ettlin, T. (2010). Objectively-assessed outcome measures: a translation and cross-cultural adaptation procedure applied to the Chedoke McMaster Arm and Hand Activity Inventory (CAHAI). BMC Medical Research Methodology, 10, 106. Find it on PubMed 

Year published

2013 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 6/27/2014 2:06 PM  by Jason Raad 
Last modified at 7/14/2016 11:26 AM  by Jason Raad