• The Action Research Arm Test (ARAT) is a standardized observational performance measure that evaluates a person’s ability to use their arm and hands to handle objects using grasp, grip, pinch and gross motor movements.
  • For the performance of the test, the participant is sitting in a chair with a firm back and no armrest:
    • Grasp tasks require the participant to lift testing materials from the surface of the table to a shelf located 37 cm above the starting point.
    • Grip-related tasks require the individual to grip testing materials and move them from one side of the table to the other.
    • Pinching tasks require the participant to perform similar movements to those in the grip subscale, but with the use of a fine motor pincer grip instead.
    • Gross movement tasks require the individual to move their testing arm to different resting positions, including on top of their head, behind their head, or to their mouth.

Clinical Considerations

The ARAT is frequently used in clinical neurorehabilitation practice and research, mainly in people with stroke, brain injury or multiple sclerosis. It was originally described by Lyle in 1981 as a modified version of the Upper Extremity Function Test.

ICF Domain

Activity ▶ Mobility

Administration

Clinician-administered.

Length

5-15 minutes.

Number of Items

19 items, categorized into 4 subscales:

  • Grasp (6 items).
  • Grip (4 items).
  • Pinch (6 items).
  • Gross motor movement (3 items).

Equipment

  • Chair without armrests
  • Table
  • Wooden blocks of various sizes
  • Cricket ball
  • Sharpening stone
  • Alloy tubes
  • Washer and bolt
  • Jug and glass or two glasses
  • Marbles
  • Ball bearings
  • Tin lid
  • Plank

Scoring

  • Each limb is scored separately. Task performance is rated on a 4-point scale, ranging from 0 (no movement) to 3 (movement performed normally). Scores range from 0-57 points, with a score of 57 indicating better performance.
  • Items are arranged in order of decreasing difficulty (the most difficult task is examined first). If the highest score is obtained for the first task, it is inferred that all tasks less difficult could be completed, and thus, can move on to the next subtest (for faster test administration).

Languages

English.

Training Required

None.

Availability

Measurement Property Summary

# of studies reporting psychometric properties: 3

Interpretability

MCID: not established in SCI population
SEM: not established in SCI population
MDC: not established in SCI population

Reliability – Not established

Not established in SCI.

Validity – Moderate to High

  • Moderate correlation with SCIM-III subscales:
    • SCIM self-care: r = 056 (p<0.01)
    • SCIM mobility: r = 0.33
    • SCIM total: 0.29

(Lili et al. 2023; n=25; 18 males, 7 females; mean (range) age: 58.4 (44.6-72.2) years; injury level: 17 cervical, 8 thoracic; ASIA A-D; mean (SD) time since injury: 17.5 (15.4) years)

  • Moderate to High correlation with kinematic end-point measures of:
    • Movement time:
      • Reaching: r = -0.41 (p < 0.05)
      • Forward transport: r = -0.71 (p < 0.01)
      • Backward transport: r = -0.58 (p < 0.01)
      • Total movement time: r = -0.70 (p < 0.01)
    • Smoothness:
      • Reaching and forward transport: r = -0.89 (p < 0.01)
      • Backward transport and returning: r = -0.71 (p < 0.01)
      • Total number of movement units: r = -0.82 (p < 0.01)
    • Movement pattern:
      • Elbow flexion (reaching): r = 0.66 (p < 0.01)
      • Wrist angle (reaching and forward transport): r = -0.60 (p < 0.01)
      • Trunk displacement: r = -0.52 (p < 0.01)

(Lili et al. 2021; n=25; 18 males, 7 females; mean (range) age: 58.4 (44.6-72.2) years; injury level: 17 cervical, 8 thoracic; ASIA A-D; mean (SD) time since injury: 17.5 (15.4) years)

  • High correlation with the ReJoyce Hand Function Test: r2 = 0.88
  • Moderate correlation with the Fugl-Meyer Assessment: r2 = 0.53

(Kowalczewski et al. 2011; n=13; age between 24 and 56 years; injury level: C5-C6)

Responsiveness

No values were reported for the responsiveness of the ARAT for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the ARAT for the SCI population.

Reviewers

Dr. Janice Eng, Dr. Carlos L. Cano-Herrera, Matthew Querée

Date Last Updated

31 December 2024

Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Independence and upper extremity functioning after spinal cord injury: a cross-sectional study. Sci Rep. 2023; 13: 3148. doi: 10.1038/s41598-023-29986-y.
https://pubmed.ncbi.nlm.nih.gov/36823179/

Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Associations between upper extremity functioning and kinematics in people with spinal cord injury. J Neuroeng Rehabil. 2021; 18: 147. doi: 10.1186/s12984-021-00938-9.
https://pubmed.ncbi.nlm.nih.gov/34565401/

Kowalczewski J, Ravid E, Prochazka A. Fully-automated test of upper-extremity function. Annu Int Conf IEEE Eng Med Biol Soc. 2011; 2011: 7332-5. doi: 10.1109/IEMBS.2011.6091710.
https://pubmed.ncbi.nlm.nih.gov/22256032/

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