Development of the Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK)

Objective: To develop the Hong Kong version of the Functional Test for the Hemiplegic Upper Extremity (FTHUE-HK) for patients with stroke in a Hong Kong Chinese community. Methods: Content validity of the prototype was established by a panel of occupational therapists who are experts in the field of neurological rehabilitation. New items relevant to the local culture were constructed. All items were reviewed with regard to internal consistency, and false positive and negative rates after implementation in a preliminary sample of 40 stroke patients. Fifty-seven stroke patients were recruited from eight local hospitals to form a convenience sample in which the inter-rater and test-retest reliabilities, and concurrent validity of the final version of the FTHUE-HK could be established. Results: There was high sensitivity and specificity for test items within each functional level (i.e. recovery stage). Satisfactory inter-rater agreement on both testing procedure and functional levels was documented. Significant correlations between the functional levels and the upper extremity and hand subscores of the Fugl-Meyer Assessment (FMA) (r = 0.88 and r = 0.88, respectively), and the self-care subscore of the Functional Independence Measure (FIM) (r = 0.46) were found. Regression analysis indicated that 86% of the variance of the functional levels could be explained by hand and upper extremity subscores of the FMA. However, there was no significant relationship with age, gender, side of hemiparesis, and duration post-stroke. Conclusion: The findings substantiate the psychometric properties of the instrument, and the application of this unique hemiplegic upper extremity functional test is highly indicated in the context of the local culture.