Table 1.

Quantitative measures for the assessment of paresis, its associated impairments, and upper extremity function

	TESTS	ADDITIONAL INFORMATION
Weakness	Muscle strength testing	Clinical muscle testing provides an easy to follow measure of strength. Assessment by dynamometers (in unit of weight) are more sensitive, but also more variable. Force was thought to be an important function of motor cortex, but more recent studies indicate the measures of dexterity or speed may be more functionally meaningful.
	Active range of motion	Quantitative assessment of range of motion (in degrees). It has been shown to be associated with motor outcome. Testing two joints (one proxiumal e.g. shoulder flexion and one distal e.g. finger extension) captures around 75% variance in upper extremity motor function at 3 months post stroke
	Motricity Index	This is a standardized scale that combines muscle strength scores (above) from 3 movements from each limb. For the upper extremity, the 3 movements are shoulder abduction, elbow flexion, and pinch force on a cube. For the lower extremity, the 3 movements are hip flexion, knee extension, and ankle dorsiflexion. The total score (0- 100, 100 = normal) provides a single value that quantifies paresis in a way that is easy to understand by patients and families.
Spasticity	Modified Ashworth Scale	Interval assessment of spasticity. Spasticity is thought to limit function but in the overwhelming majority of subjects treatment of spasticity does not improve function. Conversely, improvement of voluntary control of movement also decreases spasticity. Treatment of spasticity should not precede or limit training of voluntary movements.
Fractionation	Fugl-Meyer Scale	This scale is commonly used in research studies to measure global motor impairment in each limb. Items are rated on quality of movement. Compared to the motricity index, this instrument takes longer to administer and has more variability in scoring.
Higher order planning deficits	Naturalistic Action test ADL-observation test Florida Apraxia Battery	Clinical scales for apraxia. Unknown their long-term sensitivity in measuring motor outcome.
Upper extremity function	Action Research Arm Test	Popular criterion scale of motor function that has strong psychometric properties and is used widely around the world. Test kits can be built from published references for low cost. Quick to administer, particularly for very low-functioning and very high-functioning patients
	Wolf Motor Function Test	Popular timed and criterion-rated scale of motor function developed for CIMT research studies. Measures same construct of upper extremity function as the test above, takes slightly longer to administer.
	9 Hole Peg Test	Timed test to specifically assess finger dexterity. Published age- and gender-specific norms are available for comparison. Less appropriate for lower functioning patients. Factor analyses indicates it measures the same construct of upper extremity function as the tests above
	Box & Block Test	Timed test to grasp and release 1 inch cube blocks. Used for a variety of patient populations to assess upper extremity function. Less common now than in earlier decades.
	Stroke impact scale Hand function and activity subscales	Self- report measure of impairment, function, and disability after stroke. Highly valuable for its ability to assess stroke-specific problems and outcomes. Can be done in waiting rooms as a traditional questionnaire, via interview, telephone, mail, and/or by caregivers. Hand Function subscale scores are correlated to above measures of upper extremity function.