Kursschulung: Ad-AHA Stroke

The Ad-AHA Stroke provides a new perspective on evaluating hand function in adults or adolescents who have an acquired hemiparesis. It is a further development of the Assisting Hand Assessment (AHA), which has been successfully used in children with unilateral cerebral palsy for about 10 years. This new version, Ad-AHA Stroke is now ready for use! The Ad-AHA Stroke measures and describes the effectiveness with which a person with hemiparesis makes use of his/her affected hand (assisting hand) during bimanual activity performance. The Ad-AHA Stroke is scored from observation of a 10-15 minutes video recorded semi-structured activity requiring bimanual use. The AHA is then scored on observable performance skills described by nineteen items graded on a four-point rating scale. Ad-AHA Stroke is a standardized test intended for people with hemiparesis after acquired brain injury from teenage years to older adults.

The Ad-AHA Stroke was developed in several steps:

1. establishing the content of the tasks in the test situation from which
   bimanual performance can be observed and rated
2. constructing a research version of test items and scoring criteria
3. pilot testing of the research version of the scale to establish face validity and concurrent validity with other tests and
4. evaluation of internal scale validity by use of Rasch measurement model
   analysis.

The Rasch analysis resulted in a final scale demonstrating a unidimensional construct and high potential for sensitivity to measure change (manuscript in preparation). The Rasch-derived item difficulty information can be used to target interventions promoting functional hand use. The course teaches the Ad-AHA Stroke Version 1.0. It is conducted in two steps. First, a 2½-day training course is given including information about the test construct, testing procedure and scoring practice on a range of patients from videos. A manual with detailed scoring criteria and a computer based scoring form is provided during the course.

To achieve certification, the participant is to complete six calibration cases and get satisfactory results (within 3 months). Some of these from videos distributed at the course, and some self-produced Ad-AHA Stroke sessions. Individual feedback of these cases is provided.

Test equipment can be gathered by participants following instructions in the manual.

Aims and objectives

On completion of the course participants will be able to:

• Demonstrate the set up, conduct and video record an Ad-Assisting Hand Assessment session and produce reliable scores according to
  the criteria in the manual
• Verbalize the concept and construct of the test and its psychometric properties
• Interpret and communicate the outcome of the test.