Inter-Rater Reliability of the Chedoke Arm and Hand Activity Inventory in an Acquired Brain Injury Population

Abstract

Background: Motor impairments are common sequelae of Acquired Brain Injuries (ABI). An estimated 55-75% of ABI survivors have on-going limitations in UL function. Objective measures of UL function that have established validity and reliability in the ABI population are not readily available in the literature. The Chedoke Arm and Hand Inventory (CAHAI) is an assessment used with the stroke population. There are 4 versions of this assessment; a 13 item version and 3 shortened ones. The main purpose is to assess how much the affected UL contributes to a bilateral task. The CAHAI has strong reliability and validity in this population; however, it is unknown whether this measure can be used with other clinical populations such as ABI.

Purpose: The purpose of this study was to estimate the inter-rater reliability of the Chedoke Arm and Hand Activity Inventory (CAHAI) when used with persons with ABI including 3 shortened versions of the measure.

Methods: This is an observational parameter estimation study. Participants were recruited from an in-patient ABI rehabilitation program. The administration of the CAHAI was video recorded for 6 persons with ABI. The videos were assessed by 6 clinicians to estimate inter-rater reliability. A Latin square design was used to balance the order raters evaluated the videos.

Analysis: A repeated measures ANOVA was performed and the variance components were used to calculate an intra-class correlation coefficient (ICC) and standard error of measurement (SEM) with 95% confidence intervals (CI).

Results: Inter-rater reliability was high for all versions: CAHAI-7 ICC= 0.96 (95% CL: 0.89-0.99, SEM 2.65); CAHAI-8 ICC= 0.96 (95% CL: 0.90-0.99, SEM 2.72); CAHAI-9 ICC= 0.95 (95% CL: 0.85-0.99, SEM 3.49); CAHAI -13 ICC=0.96 (95%CL: 0.88-0.99, SEM 3.35).

Conclusions: These results suggest the CAHAI is highly reliability in the ABI population. The shortened versions may be particularly useful when time constraints or patient tolerance are an issue.