J Neurol Neurosurg Psychiatry 83:594-600 doi:10.1136/jnnp-2011-300929
  • Cerebrovascular disease
  • Research paper

Construction and pilot assessment of the Upper Limb Assessment in Daily Living Scale

  1. Charles Benaïm11
  1. 1Service de Rééducation Neurologique, CHRU et Université de Lille, Lille, France
  2. 2Service de Médecine Physique et de Réadaptation, CHU, Université de Nîmes, France
  3. 3Monitoring Force Group, Maisons-Laffitte, France
  4. 4Service de MPR, CHU, Université de Toulouse, Toulouse, France
  5. 5Service de MPR, CHU, Université de Besançon, Besançon, France
  6. 6Service de MPR, AP-HP, Université de Versailles-Saint Quentin, France
  7. 7Service de MPR, CHU, Université de Bordeaux, Bordeaux, France
  8. 8Service de MPR, AP-HP, Lariboisière-Fernand Widal, Université de Paris, Paris, France
  9. 9Service de MPR, CHU, Université de Marseille, Marseille, France
  10. 10Merz Pharma France, Nanterre, France
  11. 11Service de MPR, INSERM CIE1 and INSERM 803, CHU, Université de Dijon, Dijon, France
  1. Correspondence to Dr M Rousseaux, Service de Rééducation Neurologique, Hôpital Swynghedauw, CHRU, Lille Cedex 59037, France; marc.rousseaux{at}
  1. Contributors All authors contributed to the conception and design, acquisition of the data or analysis and interpretation of the data; drafting of the article or revising it critically for important intellectual content; and final approval of the version to be published.

  • Received 9 July 2011
  • Revised 27 December 2011
  • Accepted 13 February 2012
  • Published Online First 6 March 2012


Objective The upper limb function of hemiplegic patients is currently evaluated using scales that assess physical capacity or daily activities under test conditions. The present scale, the Upper Limb Assessment in Daily Living (ULADL) Scale, was developed to explore the subjective and objective functional capacities of such patients in a proximal to distal sequence.

Methods A group of experts constructed a scale addressing 17 upper limb functions (five active passive and 12 active) which could be explored by a questionnaire (Q) and a test (T). Reproducibility, internal consistency, concurrent validity (Rivermead Motor Assessment (RMA)) and learning effect were estimated in a multicentre study.

Results 49 stroke patients were each rated three times within 7 days by a total of 21 physicians, yielding a total of 142 ratings. The ULADL took 16±8 min to complete compared with 9±5 min for the RMA. Cronbach's alpha coefficient was 0.95 for Q and 0.97 for the practical tests (T). The global Q and T scores, and in particular the global Q score, were slightly higher at the second rating. The intra-rater intraclass correlation coefficient (ICC) was 0.65 (95% CI (0.44 to 0.79)) for Q and 0.97 (0.95 to 0.98) for T, and the inter-rater ICC was 0.95 for both Q and T. The Bland and Altman method showed good intra- and inter-rater reliability with no systematic trend. Correlation coefficients for ULADL versus RMA were >0.80 for both Q and T.

Conclusions The ULADL Scale has good psychometric properties and can explore patients with different degrees of upper limb impairment.


  • Funding This research was supported by Merz Pharma France (Nanterre).

  • Competing interests None.

  • Ethics approval The observational study was approved by the French Data Protection Authority (CNIL).

  • Provenance and peer review Not commissioned; externally peer reviewed.

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