Frenchay Arm Test (FAT)

Overview

A literature search was conducted to identify all relevant publications on the psychometric properties of the Frenchay Arm Test (FAT) in clients with stroke. Two studies were found and have been reviewed in this module. More studies are required before definitive conclusions can be drawn regarding the reliability and validity of the FAT.

Floor/Ceiling Effects

No studies have examined the floor/ceiling effects of the FAT in clients with stroke.

Reliability

Internal constancy:
No studies have examined the internal consistency of the FAT in clients with stroke.

Intra-rater reliability:
Heller, Wade, Wood, Sunderland, Hewer, and Ward (1987) examined the intra-rater reliability of the FAT, Nine-Hole Peg Test (NHPT), Finger Tapping Rate (Lezak, 1983), and Grip Strength (Mathiowetz, Kashman, Volland, Weber, Dowe, & Rogers, 1985) in 10 patients with subacute stroke. Participants were re-assessed with a 2-week interval by the same rater. In this study, results describe the range of reliability of the four measures mentioned above, and values for each individual measure were not provided. Spearman rho correlation coefficient was adequate to excellent (ranging for all four measures from r = 0.68 to 0.99).
Note: Although is not possible to discern the exact value for the FAT reliability, all values were considered adequate to excellent and statistically significant, suggesting that the FAT may be reliable with stable stroke clients.

Inter-rater reliability:
Heller et al. (1987) examined the inter-rater reliability of the FAT, Nine-Hole Peg Test (NHPT), Finger Tapping Rate (Lezak, 1983), and Grip Strength (Mathiowetz et al., 1985) in 10 patients with subacute stroke. Participants were assessed twice within a week by two raters. Spearman rho correlation coefficients were excellent (ranging for all four measures from r = 0.75 to 0.99).
Note: In this study, individual values for each measure were not provided. Although is not possible to discern the exact value for the FAT reliability, all values were considered excellent.

Test-retest:
No studies have examined the test-retest reliability of the FAT in clients with stroke.

Validity

Content validity
No studies have examined the content validity of the FAT in clients with stroke.

Criterion validity
Concurrent validity:
No studies have examined the concurrent validity of the FAT in clients with stroke.

Predictive validity:
No studies have examined the predictive validity of the FAT in clients with stroke.

Sensitivity/specificity:
Heller et al. (1987) investigated the specificity of the FAT and the Nine Hole Peg Test (NHPT) in 56 clients with chronic stroke. All of the clients that scored less than 5/5 on the FAT were correctly identified as having impaired dexterity, as identified by using the normal cut-off scores for the NHPT. However, 48 percent of patients that scored 5/5 on the FAT scored in the below normal range on the Nine Hole Peg Test. These results indicate that the NHPT is more sensitive than the FAT for detecting impaired upper extremity function in clients with stroke.

Parker, Wade & Hewer (1986) compared the specificity of the FAT and the Nine-Hole Peg Test (NHPT) in 187 clients with sub-acute stroke. Participants that were able to successfully place nine pegs in the pegboard were further categorized according to those who completed the NHPT in less than 19 seconds (n=37) and those who required over 19 seconds (n=69). For the FAT, 114 participants score 5/5, 33 participants scored in the middle range (1/5 – 4/5) and 36 participants scored 0/5. Researchers concluded that the NHPT is more sensitive than the FAT because 13 percent of participants who scored perfectly on the FAT placed less than 9 pegs on the NHPT and all participants who scored perfectly on the NHPT (9 pegs placed in less than 19 seconds) also scored 5/5 on the FAT.

Construct validity
Convergent/Discriminant:
No studies have examined the discriminant validity of the FAT in clients with stroke.

Known Groups:
No studies have examined the known groups validity of the FAT in clients with stroke.

Responsiveness
No studies have examined the responsiveness of the FAT in clients with stroke.

References
  • Heller, A., Wade, D.T., Wood, V.A., Sunderland, A., Langton Hewer, R., & Ward, E. (1987). Arm function after stroke: Measurement and recovery over the first three months. Journal of Neurology, Neurosurgery, and Psychiatry, 50, 714-719.
  • Hsieh, C-L., Hsueh, P. Chiang, F-M., & Lin, P-H. (1998). Inter-rater reliability and validity of the Action Research Arm Test in stroke patients. Age and Ageing, 27, 107-113.
  • Parker, V.M., Wade, D.T., & Langton Hewer, R. (1986). Loss of arm function after stroke: Measurement, frequency, and recovery. International Rehabilitative Medicine, 8, 69-73.
  • Wade, D.T., Langton-Hewer, R., Wood, V.A., Skilbeck, C.E., & Ismail, H.M. (1983). The hemiplegic arm after stroke: Measurement and recovery. Journal of Neurology, Neurosurgery and Psychiatry, 46, 521-524.