Development of the Italian version of the Motricity Index and evaluation of its reliability in adults with stroke.
Diego Longo, Stefano Doronzio, Michele Piazzini and 11 others
PMID 39749422WHAT IT FOUND
The Italian Motricity Index reliably measures motor impairment on the more affected side after stroke, but shows poor agreement between therapists on the less affected side.
Expect measurement error of 9-25% on the affected side, so small score changes are not true improvements.
Key findings
01Test-retest reliability was excellent for total scores on the more affected side, with correlation coefficients between 0.953 and 0.975.
02Inter-rater reliability was poor for the less affected side, with correlation coefficients well below 0.90 for upper limb scores.
03Measurement error on the more affected side was significant, with limits of agreement ranging from 13 to 19 percent higher and 6 to 16 percent lower than the median score.
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 only included patients in the subacute phase of stroke recovery, so the results may not apply to chronic stroke survivors. Retesting happened within three days, which risks therapists remembering previous scores and unconsciously repeating them, potentially making the tool look more consistent than it is. Half of the eligible patients were excluded due to cognitive issues, instability, or refusal, so the results may not apply to patients with communication difficulties or complex medical needs. The tool was not validated against other measures of motor function, so it is unclear if it accurately measures what it claims to measure.
Declared interests
The authors declared no conflicts of interest. The study was funded by the Italian Minister of Health.
The easy way to misread this
Do not assume a change in the Motricity Index score reflects a patient's actual recovery. The study shows a measurement error of 9% to 25% on the affected side, meaning small score differences are likely just testing noise. Additionally, do not rely on scores from the less affected side, as agreement between therapists was poor.