Convergent Validity and Responsiveness of the SULCS.
Jayme S Knutson, Amy S Friedl, Kristine M Hansen and 2 others
PMID 30148996WHAT IT FOUND
The SULCS test tracks upper-limb recovery in stroke patients as accurately as longer, more complex measures.
It correlates strongly with established tests and shows no scoring gaps, offering a quicker way to monitor hand function changes over six months.
Key findings
01SULCS scores showed strong positive correlations with the Action Research Arm Test, Box and Block Test, and Fugl-Meyer Assessment at baseline.
02All four measures demonstrated similar responsiveness to change, with no statistically significant differences in standardized response means at 12 or 36 weeks.
03The SULCS had acceptable floor and ceiling effects (less than 15% of participants), unlike the Box and Block Test which showed floor effects at three time points.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was not pre-specified in the original trial protocol and was not powered specifically for these validation analyses. The sample size decreased from 61 to 40 participants by the end of the study due to withdrawals and loss to follow-up. Only patients with moderate to severe upper limb impairment were included, so findings may not apply to those with mild impairment. Most participants were less than 15 months post-stroke, limiting generalizability to chronic stroke patients beyond two years. Missing data were not replaced, which may bias the results.
Declared interests
Funding was provided by the National Institutes of Health (Extramural). No other conflicts of interest were reported.
The easy way to misread this
Do not assume the SULCS is superior to other measures. It showed similar responsiveness to the AMAT, BBT, and FMA, not greater sensitivity. Its main advantage is administration time, not accuracy.