Table 1.

Assessment of common upper extremity impairments after stroke

Impairment	Assessment	Time to administer	Description	Reliability	Details
Paresis	Motricity Index 119, 120	3 min	Manual Muscle Test Score is given for shoulder abduction, elbow flexion and pinch grip. Together these scores are converted to a total force production score for each UE ranging from 0 (no strength) to 100 (full strength)	Intrarater =no established studies Interrater ?=0.88	Paresis after stroke similarly affects movement at each segment. This means that one needs to test only a UE few segments. The Motricity Index is quick and provides a total force score for the entire UE.
	Grip Strength Pinch Strength 121, 122	2-3 min	Hand-Held Dynamometer to assess kilograms or pounds of force. Age- and genderappropriate normative values available	Intrarater r=0.80 Interater r=0.97	Measurement of handgrip strength has been shown to predict motor performance and functional independence 64, 65
Fractionation of Movement	Observation of fractionated movement, paresis assessment	Observed during paresis assessment; 5-6 min	Presence or absence of movement fractionation observed; note any substitutions or associated reactions	N/A	As part of the paresis assessment, fractionation of movement can be assessed.
Muscle Tone	Modified Ashworth Scale 31	< 5 min	Six point scale from 0 (no increase in muscle tone) to 4 (affected part is rigid)	Intrarater =no established studies Interrater tau=0.85	The elbow flexors are most easily and commonly assessed in the UE.
Somatosen -sation	Light Touch	1-2 min	Light touch sensation can be noted as Intact, Impaired (i.e. less feeling compared to other side), or Absent based on one light stroke to the skin of the UE	N/A	Loss of somatosensation after stroke typically occurs across multiple modalities and across the entire limb. Light touch is the most common modality assessed. Results from a single, representative modality at 1-2 sites are an indicator that similar deficits exist in other modalities and at other locations.
Multiple Impairments	Fugl-Meyer, Upper Limb Section 123,84	30 min	The upper limb section has 33 items including: movement observation, reflex testing, grasp testing and coordination. Three point scale from 0 (unable to perform) to 2 (able to perform) totaling 66 for the upper limb portion.	Intrarater ICC= 0.99 Interrater ICC=0.96	The Fugl-Meyer provides a global assessment of UE impairment. Often a quicker measure of paresis is selected over the Fugl- Meyer to decrease testing burden 124.