Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)
May 9–10
Live and Online
Offered by Academy, Shirley Ryan AbilityLab
The AMAT evaluates disabilities in upper extremity function in activities of daily living (ADL) using a quantitative and qualitative measure.
AMAT-13: 8
AMAT-10: 23
60 minutes
AMAT-12: 31 to 60 minutes
AMAT-10: 15 to 20 minutes
Initially reviewed by Jane Sullivan PT, DHS, MS and the Stroke EDGE task force of the Neurology Section of the APTA. Follow-up review by Elizabeth Blaschak, OTS; Jenna Colangelo, OTS; and Katherine Kostecki, OTS from the University of Illinois at Chicago.
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 (SCI EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) 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 | R | R |
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 | R | R | R | R |
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 | Yes | Not reported |
Limitations: Very lengthy to complete. Client should have some active movement capacity in the involved arm. The AMAT has been used in post stroke UE intervention trials examining constraint induced movement therapy, electrical stimulation, and repetitive task training. Ability to follow multi-step directions verbally or through modeling is a pre-requisite (O’Dell et al., 2011). Most ADL test items have multiple sub-tasks, which could present challenges if client has severe cognitive or language limitations (O’Dell et al., 2011). Instructions can be repeated and cues provided throughout the test, as it is not a test of cognitive ability (O’Dell et al., 2011).
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Stroke:
(Kopp et al, 1997; n = 33 subacute stroke inpatients with moderate to mild upper extremity motor deficit; median age = 66 years; sex = 12 females; median Motricity Index Arm Score = 89; median chronicity = 43 days)
Stroke: (Fulk, 2017, n=146, age=57.1 ± 10.96 years, mean time since stroke onset for participants in sample = 59.37 ± 63.22 [SD] months; 88 participants with hemiparesis affecting their right UEs; 82 participants with hemiparesis affecting their dominant UEs)
Minimal Detectable Change in AMAT Based on Therapists’ Perception of Change
Minimal Detectable Change in AMAT Based on Participants’ Perception of Change
Stroke: (Fulk, 2017, n=146, age=57.1 ± 10.96 years, mean time since stroke onset for participants in sample = 59.37 ± 63.22 [SD] months; 88 participants with hemiparesis affecting their right UEs; 82 participants with hemiparesis affecting their dominant UEs)
MCID in AMAT Based on Therapists’ Perception of Change
MCID in AMAT Based on Participants’ Perception of Change
Stroke:
(O’Dell et al., 2013; n = 32 subjects prior to upper extremity robotic treatment; mean age = 56 years (SD = 12.4); age range = 35-85; gender = 72% male; ethnicity = 56% white, 28% black, 16% other; handedness = 88% right-handed; years post-stroke: mean = 4.1 (SD = 4.5; range = 0.8-25.2))
Stroke: (Fulk, 2017, n=146, age=57.1 ± 10.96 years, mean time since stroke onset for participants in sample = 59.37 ± 63.22 [SD] months; 88 participants with hemiparesis affecting their right UEs; 82 participants with hemiparesis affecting their dominant UEs)
Mean score of AMAT (SD)
Stroke:
(Kopp et al, 1997)
Stroke:
(Kopp et al, 1997)
(Daly et al., 2005 AMAT-13; 10 subjects > 12 months post-stroke)
Stroke:
(O’Dell et al., 2013; n = 32 subjects prior to upper extremity robotic treatment; mean age = 56 years (SD = 12.4); age range = 35-85; gender = 72% male; ethnicity = 56% white, 28% black, 16% other; handedness = 88% right-handed; years post-stroke: mean = 4.1 (SD = 4.5; range = 0.8-25.2))
Stroke:
(Kopp et al, 1997)
(Chae et al, 2003)
Stroke:
(O’Dell et al., 2013; n = 32 subjects prior to upper extremity robotic treatment; mean age = 56 years (SD = 12.4); age range = 35-85; gender = 72% male; ethnicity = 56% white, 28% black, 16% other; handedness = 88% right-handed; years post-stroke: mean = 4.1 (SD = 4.5; range = 0.8-25.2))
(Daly et al., 2005) Participants were 12 people (21-62 years of age; 6 male and 6 female) who were 1 to 4 years post-stroke.
(Kopp et al, 1997)
(Chae et al, 2003; n = 30 chronic stroke survivors)
Stroke:
O’Dell et al. (2013) found consistencies between the AMAT-9 and the Rasch model expectations, even with the few participants in the study.
Stroke:
The AMAT time of performance exhibited significant ceiling and floor effects with respect to the Fugl-Meyer Assessment (Chae et al, 2003).
Stroke: (Fulk, 2017, n=146, age=57.1 ± 10.96 years, mean time since stroke onset for participants in sample = 59.37 ± 63.22 [SD] months; 88 participants with hemiparesis affecting their right UEs; 82 participants with hemiparesis affecting their dominant UEs)
Sensitivity in AMAT Based on Therapists’ Perception of Change
Sensitivity in AMAT Based on Participants’ Perception of Change
Stroke:
In individuals with subacute stroke and mild to moderate movement deficits, the AMAT detected the difference in change occurring as a result of the passage of 1 versus 2 weeks (Kopp et al, 1997).
AMAT intermediate responsiveness = 0.98; FMA was highest at 1.26; WMFT was lowest at 0.81; ARAT SRM = 0.89 (O’Dell et al, 2013).
Chae, J., Labatia, I., et al. (2003). "Upper limb motor function in hemiparesis: concurrent validity of the Arm Motor Ability test." Am J Phys Med Rehabil 82(1): 1-8. Find it on PubMed
Daly, J.J., Hogan, N., Perepezko, E.M., Krebs, H.I., Rogers, J.M., Goyal, K.S., …Ruff, R.L. (2005). Response to upper-limb robotics and functional neuromuscular stimulation following stroke. Journal of Rehabilitation Research & Development, 42(6), 723-736. Find it on PubMed
Fulk G, Martin R, Page SJ. Clinically Important Difference of the Arm Motor Ability Test in Stroke Survivors. Neurorehabilitation and Neural Repair. 2017;31(3):272-279. doi:10.1177/1545968316680486
Kopp, B., Kunkel, A., et al. (1997). "The Arm Motor Ability Test: reliability, validity, and sensitivity to change of an instrument for assessing disabilities in activities of daily living." Arch Phys Med Rehabil 78(6): 615-620. Find it on PubMed
O’Dell, M.W., Kim, G., Rivera Finnen, L., Polistena, C. (2011). Clinical Implications of Using the Arm Motor Ability Test in Stroke Rehabilitation. Archives of Physical Medicine and Rehabilitation, 92, 830-836.
O’Dell, M. W., Kim, G., Rivera, L., Fieo, R., Christos, P., Polistena, C., Fitzgerald, K., . . . Delia, G. (2013). A Psychometric Evaluation of the Arm Motor Ability Test. J Rehabil Med., 45(6), 519-527. https://doi.org/10.2340/16501977-1138. Find it on PubMed
Poole, J.L., & Whitney, S.L. (2001). Assessments of motor function post stroke: A review. Physical and Occupational Therapy in Geriatrics, 19(2), 1-22.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.