A behavioral observation system for quantifying arm activity in daily life after stroke.

OBJECTIVE

Evaluate psychometric properties of the Functional Arm Activity Behavioral Observation System (FAABOS) for measuring hemiparetic arm use.

PARTICIPANTS AND MEASURES: All participants acquired their brain injury > 1 year prior to study entry; most had mild-to-moderate upper-extremity hemiparesis. In Study 1, 9 stroke survivors wore accelerometers and were videotaped for 15 min in the hospital or at home after they were asked to behave as usual. In Study 2, 1 traumatic brain injury and 8 stroke survivors wore accelerometers and were videotaped at home for 3 days with a motion-triggered camera. Observers independently rated 15-min segments of the Study 1 and 2 videotapes in 2-s blocks with a 4-step arm-activity coding scheme.

RESULTS

Interrater reliability was excellent; the mean Cohen's kappa in each study was > or = .84. For data from both studies combined, validity was supported by a strong correlation between amount of hemiparetic arm functional activity, as determined by the observers, and the ratio of hemiparetic to other arm movement, as determined by accelerometry.

CONCLUSION

FAABOS reliably and validly quantifies amount of spontaneous hemiparetic arm activity outside the laboratory.