***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background and Purpose — The Motor Activity Log ( MAL ) is a semistructured interview for hemiparetic stroke patients to assess the use of their paretic arm and h and ( amount of use [ AOU ] ) and quality of movement [ QOM ] ) during activities of daily living . Scores range from 0 to 5 . The following clinimetric properties of the MAL were quantified : internal consistency ( Cronbach α ) , test – retest agreement ( Bl and and Altman method ) , cross-sectional construct validity ( correlation between AOU and QOM and with the Action Research Arm [ ARA ] test ) , longitudinal construct validity ( correlation of change on the MAL during the intervention with a global change rating [ GCR ] and with change on the ARA ) , and responsiveness ( effect size ) . Methods — Two baseline measurements 2 weeks apart and 1 follow-up measurement immediately after 2 weeks of intensive exercise therapy either with or without immobilization of the unimpaired arm ( forced use ) were performed in 56 chronic stroke patients . Results — Internal consistency was high ( AOU : α=0.88 ; QOM : α=0.91 ) . The limits of agreement were −0.70 to 0.85 and −0.61 to 0.71 for AOU and QOM , respectively . The correlation with the ARA score ( Spearman ρ ) was 0.63 ( AOU and QOM ) . However , the improvement on the MAL during the intervention was only weakly related to the GCR and to the improvement on the ARA , Spearman ρ was between 0.16 and 0.22 . The responsiveness ratio was 1.9 ( AOU ) and 2.0 ( QOM ) . Conclusion — The MAL is internally consistent and relatively stable in chronic stroke patients not undergoing an intervention . The cross-sectional construct validity of the MAL is reasonable , but the results raise doubt about its longitudinal construct validity Objective : To examine the psychometric properties of the sensory scale of the Fugl-Meyer Assessment ( FMA-S ) in stroke patients with a broad range of neurological and functional impairment at times from 14 to 180 days after stroke . Subjects : A total of 176 first stroke patients consecutively admitted to a university based medical centre . Design : This prospect i ve , longitudinal investigation was based on data collected at 14 , 30 , 90 and 180 days after stroke . Main outcome measures : Reliability ( inter-rater reliability and internal consistency ) , validity ( convergent and predictive validity ) and responsiveness of the FMA-S  were examined . Results : The inter-rater agreement of the total score of the FMA-S was excellent , with an intraclass correlation coefficient of 0.93 . The Cronbach 's alphas of the FMA-S at four time points after stroke ranged from 0.94 to 0.98 , indicating excellent internal consistency . However , the FMA-S showed a significant ceiling effect ( more than 44.4 % of the subjects achieving the highest score ) , poor to moderate inter-rater reliability for light touch items ( weighted kappa ranging from 0.30 to 0.55 ) , low to moderate validity ( Spearman 's rho ranging from 0.29 to 0.53 ) , and low to moderate responsiveness ( st and ardized response mean ranging from 0.27 to 0.67 ) at different post-stroke stages of recovery . Conclusions : The psychometric properties of the FMA-S in measuring sensory function do not support its clinical use in stroke patients . Further studies on methods to improve the psychometric properties of the FMA-S are needed Background and Purpose — This study compared the psychometric properties of 3 clinical balance measures , the  Berg Balance Scale ( BBS ) , the Balance subscale of the Fugl-Meyer test ( FM-B ) , and the Postural Assessment Scale for Stroke Patients ( PASS ) , in stroke patients with a broad range of neurological and functional impairment from the acute stage up to 180 days after onset . Methods — One hundred twenty-three stroke patients were followed up prospect ively with the 3 balance measures 14 , 30 , 90 , and 180 days after stroke onset ( DAS ) . Reliability ( interrater reliability and internal consistency ) and validity ( concurrent validity , convergent validity , and predictive validity ) of each measure were examined . A comparison of the responsiveness of each of the 3 measures was made on the basis of the entire group of patients and 3 separate groups classified by degree of neurological severity . Results — The FM-B and BBS showed a significant floor or ceiling effect at some DAS points , whereas the PASS did not show these effects . The BBS , FM-B , and PASS all had good reliability and validity for patients at different recovery stages after stroke . The results of effect size demonstrated fair to good responsiveness of all 3 measures within the first 90 DAS but , as expected , only a low level of responsiveness at 90 to 180 DAS . The PASS was more responsive to changes in severe stroke patients at the earliest period after stroke onset , 14 to 30 DAS . Conclusions — All 3 measures tested showed very acceptable levels of reliability , validity , and responsiveness for both clinicians and research ers . The PASS showed slightly better psychometric characteristics than the other 2 measures Objective : To begin the process of determining the best clinical tool for measuring balance in individuals post stroke . Design : Prospect i ve with descriptive and relational analyses . Setting : Rehabilitation centres and stroke support group meetings . Subjects : Seventy-five subjects who had suffered a stroke were divided into four groups based on the Duncan classification for stroke severity . Main outcome measures : The motor section of the Fugl-Meyer Assessment of Physical Performance was completed for each person to classify the motor deficit . Subjects performed  Functional Reach  twice with the nonparetic arm and the average was recorded . Subjects performed the Berg Balance Scale and the total score on the first attempt was recorded . Results : As motor impairment increased , balance ability declined and both the Functional Reach and Berg Balance Scale proved sensitive to this decline . Spearman rank correlation coefficient was excellent among the entire sample ( rs-0.78 ) . Conclusion : Subjects ' performance on the Berg Balance Scale was closely associated with performance on the Functional Reach . Therefore , the clinician may elect to use the shorter Functional Reach as a measure of balance where efficient use of time is the primary goal Background The minimal detectable change ( MDC ) is the smallest amount of difference in individual scores that represents true change ( beyond r and om measurement error ) . The MDCs of the Timed “ Up & Go ” Test ( TUG ) and the Dynamic Gait Index ( DGI ) in people with Parkinson disease ( PD ) are largely unknown , limiting the interpretability of the change scores of both measures . Objective The purpose of this study was to estimate the MDCs of the TUG and the DGI in people with PD . Design This investigation was a prospect i ve cohort study . Methods Seventy-two participants were recruited from special clinics for movement disorders at a university hospital . Their mean age was 67.5 years , and 61 % were men . All participants completed the TUG and the DGI assessment s twice , about 14 days apart . The MDC was calculated from the st and ard error of measurement . The percentage MDC ( MDC% ) was calculated as the MDC divided by the mean of all scores for the sample . Furthermore , the intraclass correlation coefficient was used to examine the reproducibility between testing sessions ( test-retest reliability ) . Results The respective MDC and MDC% of the TUG were 3.5 seconds and 29.8 , and those of the DGI were 2.9 points and 13.3 . The test-retest reliability values for the TUG and the DGI were high ; the intraclass correlation coefficients were .80 and .84 , respectively . Limitations The study sample was a convenience sample , and the participants had mild to moderately severe PD . Conclusions The results showed that the TUG and the DGI have generally acceptable r and om measurement error and test-retest reliability . These findings should help clinicians and research ers determine whether a change in an individual patient with PD is a true change Objective : To assess and to compare the reliability of the Modified Tardieu Scale with the Modified Ashworth Scale in patients with severe brain injury and impaired consciousness . Design : Cross-sectional observational comparison study . Setting : An early rehabilitation centre for adults with neurological disorders . Subjects : Thirty patients with impaired consciousness due to severe cerebral damage of various aetiologies . Measurement protocol : Four experienced physical therapists rated each patient in a r and omized order once daily for two consecutive days . Shoulder , elbow , wrist , hip , knee and ankle spasticity were assessed by the use of Modified Tardieu Scale and Modified Ashworth Scale data collection procedures . Main outcome measures : Test - retest and inter-rater reliability ( k = kappa value ) of the Modified Tardieu Scale and the Modified Ashworth Scale .  Results : The test-retest reliability of the Modified Ashworth Scale was moderate to good ( k = 0.47 - 0.62 ) and of the Modified Tardieu Scale moderate to very good ( k = 0.52 - 0.87 ) . Test - retest reliability was significantly higher within the Modified Tardieu Scale in comparison with the Modified Ashworth Scale ( Z<1.96 ; p<0.05 ) except for shoulder extensor and internal rotator muscles ( Z<1.96 ; p<0.05 ) . Although inter-rater reliability of both scales was poor to moderate ( Modified Ashworth Scale : k = 0.16 - 0.42 ; Modified Tardieu Scale : k = 0.29 - 0.53 ) , significantly higher k-values were revealed with the Modified Tardieu Scale for all tested muscle groups ( Z<1.96 ; p<0.05 ) except for wrist extensors ( Z<1.96 ; p<0.05 ) . Conclusion : In patients with severe brain injury and impaired consciousness the Modified Tardieu Scale provides higher test-retest and inter-rater reliability compared with the Modified Ashworth  Scale and may therefore be a more valid spasticity scale in adults Purpose . To determine the intrarater-reliability , interrater-reliability and normal reference scores of the Semmes Weinstein Monofilament test ( SWM ) of the feet of healthy subjects . In addition , the stability of the SWM for prospect i ve use was assessed by determining systematic changes in sensory thresholds . Methods .  Interrater-reliability  was assessed on five locations of the plantar side of both feet using monofilaments 1.65 , 2.36 , 2.44 , 2.83 , 3.22 , 3.61 , 3.84 , 4.08 , 4.31 , 5.56 , 6.65 in 60 healthy subjects by two or three investigators ( test day 1 ) . Intrarater-reliability and systematic changes in sensory thresholds were assessed 3 weeks later ( test day 22 ) by one investigator . Results . Median interrater-reliability for the five test locations for both feet was poor to moderate . Median intrarater-reliability was good for the left foot and poor to moderate for the right foot . Significantly lower median sensory thresholds were found for the first SWM measurement at test day 22 compared to the first and second measurement of test day 1 . Given the observed reliability of the SWM , a normal sensory score for the feet was situated between monofilament 3.22 and 4.08 . Conclusions . The SWM are reliable when measured by one research er . Systematic changes in sensory thresholds were observed ; therefore , the stability of the SWM for use in prospect i ve studies could not be verified Background and Purpose — Outcome measurement fidelity within and between sites of multi-site , r and omized , clinical trials is an essential element to meaningful trial outcomes . As important are the methods developed for r and omized , clinical trials that can have practical utility for clinical practice . A st and ardized measurement method and rater training program were developed for the total Fugl-Meyer motor and sensory assessment s ; inter-rater reliability was used to test program effectiveness . Methods — Fifteen individuals with hemiparetic stroke , 17 trained physical therapists across 5 regional clinical sites , and an expert rater participated in an inter-rater reliability study of the Fugl-Meyer motor ( total , upper extremity , and lower extremity subscores ) and sensory ( total , light touch , and proprioception subscores ) assessment s. Results — Intra-rater reliability for the expert rater was high for the motor and sensory scores ( range , 0.95–1.0 ) . Inter-rater agreement ( intraclass correlation coefficient , 2 , 1 ) between expert and therapist raters was high for the motor scores ( total , 0.98 ; upper extremity , 0.99 ; lower extremity , 0.91 ) and sensory scores ( total , 0.93 ; light touch , 0.87 ; proprioception , 0.96 ) . Conclusions — St and ardized measurement methods and training of therapist assessors for a multi-site , rehabilitation , r and omized , clinical trial result ed in high inter-rater reliability for the Fugl-Meyer motor and sensory assessment s. Poststroke sensorimotor impairment severity can be reliably assessed for clinical practice or rehabilitation research with these methods BACKGROUND AND PURPOSE The EuroQol measures aspects of quality of life that are highly relevant to stroke patients . It is short and simple and many stroke patients can complete the form without help . However , its validity has not been adequately assessed after stroke . We therefore assessed its concurrent and discriminant validity in a group of prospect ively studied stroke survivors . METHODS We assessed the validity of the EuroQol in a series of 152 patients with stroke who were all visited by a study nurse . 
    Output:
    
DISCUSSION Use of highly recommended OMs may provide a common set of tools enabling comparisons across patients , interventions , setting s , and studies .