Send to

Choose Destination
Front Neurol. 2019 May 29;10:540. doi: 10.3389/fneur.2019.00540. eCollection 2019.

Inter-rater and Intra-rater Reliability of the Chinese Version of the Action Research Arm Test in People With Stroke.

Author information

Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
Rehabilitation Department, Shenzhen Hospital, Southern Medical University, Shenzhen, China.
Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Department of Rehabilitation Medicine, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.


Purpose: To detect the inter-rater and intra-rater reliability of the Chinese version of the Action Research Arm Test (C-ARAT) in patients recovering from a first stroke. Methods: Fifty-five participants (45 men and 10 women) with a mean age of 58.67 ± 12.45 (range: 22-80) years and a mean post-stroke interval of 6.47 ± 12.00 (0.5-80) months were enrolled in this study. To determine the inter-rater reliability, the C-ARAT was administered to each participant by two raters (A and B) with varying levels of experience within 1 day. To determine intra-rater reliability, rater A re-administered the C-ARAT to 33 of the 55 participants on the second day. Intra-class correlation coefficients (ICCs) and Bland-Altman plots were used to analyse the inter-rater and intra-rater reliability. Results: Regarding inter-rater reliability, the total, grasping, gripping, pinching, and gross movement scores received respective ICCs of 0.998, 0.997, 0.995, 0.997, and 0.960 (all p < 0.001), indicating excellent inter-rater reliability in stroke patients. Regarding intra-rater reliability, the corresponding ICCs were 0.987, 0.980, 0.975, 0.944, and 0.954 (all p < 0.001), again indicating excellent intra-rater reliability. The Bland-Altman plots yielded a mean difference of 0.15 with 95% limits of agreement (95%LOA) ranging from -2.16 to 2.46 for the inter-rater measurements and a mean difference of -1.06 with 95%LOA ranging from -6.43 to 4.31 for the intra-rater measurement. The C-ARAT thus appeared to be a stable scoring method. Conclusions: The C-ARAT yielded excellent intra-rater and inter-rater reliability for evaluating the paretic upper extremities of stroke patients. Therefore, our results supported the use of the C-ARAT in this population.


Chinese; action research arm test; rehabilitation; reliability; stroke; upper extremity

Supplemental Content

Full text links

Icon for Frontiers Media SA Icon for PubMed Central
Loading ...
Support Center