Psychometric Validation of the In-Hand Manipulation Assessment

Objective

To determine the inter-rater reliability, and criterion and discriminant validity of the In-Hand Manipulation Assessment (IHMA) with patients after stroke.

Design

Participants were videotaped, completing the IHMA and scored by 2 blinded assessors to determine the inter-rater reliability. Stroke participants also completed the Jebsen-Taylor Hand Function Test, and healthy participants completed the Nine-Hole Peg Test to determine the validity of the IHMA.

Setting

Community and hospital settings.

Participants

A total of 46 participants with 22 healthy young adults, 14 healthy older adults and 10 people with stroke.

Interventions

Not applicable.

Main Outcome Measures

Not applicable.

Results

The inter-rater reliability of the IHMA was good (for all participants: intraclass correlation coefficient = 0.78-0.98, P≤.001; for stroke participants: Kappa statistics = 0.70-1.00, P≤.001). The IHMA demonstrated good discriminant validity between the healthy young adults and healthy older adults for time and completion scores (Ps=.012 and ≤.001). The criterion validity of the IHMA was moderate to good when compared with the Nine-Hole Peg Test (r = −0.45 to 0.84), but no significant correlation was found with the Jebsen-Taylor Hand Function Test. Modifications to the IHMA tasks and instructions were made based on the performance of participants to improve its clinical utility with people after stroke.

Conclusions

The IHMA demonstrated good inter-rater reliability, good discriminant validity, and moderate-to-good criterion validity with the Nine-Hole Peg Test. The proposed modifications to the IHMA will enhance its administration.