A reliable and valid assessment of upper limb movement quality after stroke: the observational Drinking Task Assessment.
Minnu Jose, Maria Munoz-Novoa, Margit Alt Murphy
PMID 39382398WHAT IT FOUND
The Drinking Task Assessment reliably scores upper limb movement quality after stroke in 5 to 10 minutes.
It correlates strongly with standard tests like the ARAT and Fugl-Meyer. A change of 1 point in the total score or 1 second in movement time reflects real improvement, not just measurement error.
Key findings
01The DTA shows good to excellent inter- and intra-rater reliability, with weighted kappa values above 0.71 for most items.
02The DTA total score correlates strongly with the Action Research Arm Test (r = 0.93) and the Fugl-Meyer Assessment of Upper Extremity (r = 0.74).
03A 1-point difference in the DTA total score or a 1-second difference in movement time exceeds the measurement error and indicates a real change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only 30 participants, which limits the precision of the reliability estimates. The sample was recruited from a specific region in Sweden, so results may not generalize to other populations. Responsiveness of the scale to change over time (e.g., during rehabilitation) has not yet been evaluated. Reliability was lower for the shoulder flexion and smoothness items compared to others. The study did not include participants with severe cognitive or communication impairments that prevented following instructions.
Declared interests
The study was funded by several Swedish foundations (Rune and Ulla Amlövs Foundation, P-O Ahl & J-B Wennerströms Foundation, Stroke Centrum Väst, Foundation of the Society of Neurological Diagnosis, Swedish Stroke Foundation). The funders had no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not interpret small fluctuations in the DTA score as clinical change. A difference of less than 1 point in the total score or less than 1 second in movement time falls within the measurement error and is not reliable.