Psychometric validation of the in-hand manipulation assessment

Objective: To determine the inter-rater reliability, and criterion and discriminant validity of the In-Hand Manipulation Assessment (IHMA) with patients after stroke.Design: Participants were videotaped, completing the IHMA and scored by 2 blinded assessors to determine the inter-rater reliability. Stroke participants also completed the Jebsen-Taylor Hand Function Test, and healthy participants completed the Nine-Hole Peg Test to determine the validity of the IHMA.Setting: Community and hospital settings.Participants: A total of 46 participants with 22 healthy young adults, 14 healthy older adults and 10 people with stroke.Interventions: Not applicable.Main Outcome Measures: Not applicable.Results: The inter-rater reliability of the IHMA was good (for all participants: intraclass correlation coefficient = 0.78-0.98, P≤.001; for stroke participants: Kappa statistics = 0.70-1.00, P≤.001). The IHMA demonstrated good discriminant validity between the healthy young adults and healthy older adults for time and completion scores (Ps=.012 and ≤.001). The criterion validity of the IHMA was moderate to good when compared with the Nine-Hole Peg Test (r = −0.45 to 0.84), but no significant correlation was found with the Jebsen-Taylor Hand Function Test. Modifications to the IHMA tasks and instructions were made based on the performance of participants to improve its clinical utility with people after stroke.Conclusions: The IHMA demonstrated good inter-rater reliability, good discriminant validity, and moderate-to-good criterion validity with the Nine-Hole Peg Test. The proposed modifications to the IHMA will enhance its administration.