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Arm Activity measure (ArmA)

The ArmA is a measure of difficulty in passive and active function for application following focal therapy intervention and in particular for spasticity interventions, both physical and with botulinum toxin injection. The active and passive sub-scales of the tool are treated as separate constructs, but nevertheless have a relationship and are both important in the achievement of clinically relevant change. The ArmA is likely to have utility in practice for evaluation of spasticity intervention (often for passive function) and other focal rehabilitation interventions such as task practice training for active function improvement.


  • The ArmA is a valid, reliable and responsive measure for the evaluation of treatment in upper limb spasticity and other focal interventions related to rehabilitation of the arm following neurological injury or damage.
  • Principal components analysis confirmed that the active and passive function subscales formed two separate constructs. 
  • Mokken analysis corroborated the findings of the principal components analysis and demonstrated scaling using the monotone homogeneity model (Item H>0.5 for all items). 
  • Cronbach’s alpha was 0.85 and 0.96, respectively, for the passive and active function subscales. 
  • Item level test–retest agreement ranged from 92-97.5% (quadratic-weighted Kappa 0.71-0.94). 
  • In the subgroup treated for spasticity with botulinum toxin (n = 58), the ArmA passive function scale identified a significant difference between responder and non-responder groups (Mann Whitney U = 0.85, p < 0.01). 
  • Respondents reported the ArmA to be relevant (77%), easy to use (90%) and timely to complete (83% under 10 minutes). 



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