Abstract
BackgroundBrachial hemiparesis is one of the most frequent sequelae of stroke, leading to important functional disability given the role of the upper limb in executing activities of daily living (ADL). The Stroke Upper Limb Capacity Scale (SULCS) is a stroke-specific assessment instrument that evaluates functional capacity of the upper limb based on the execution of 10 tasks. The objective of this study is the transcultural adaptation and psychometric validation of the Portuguese version of the SULCS.MethodsA Portuguese version of the SULCS was developed, using the process of forward-backward translation, after authorisation from the author of the original scale. Then, a multicentre study was conducted in Portuguese stroke patients (n = 122) to validate the psychometric properties of the instrument. The relationship between sociodemographic and clinical characteristics was used to test construct validity. The relationship between SULCS scores and other instruments was used to test criterion validity.ResultsSemantic and linguistic adaptation of the SULCS was executed without substantial issues and allowed the development of a Portuguese version. The application of this instrument suggested the existence of celling effect (19.7% of participants with maximum score). Reliability was demonstrated through the intraclass correlation coefficient of 0.98. As for construct validity, SULCS was sensible to muscle tonus and aphasia. SULCS classification impacted the scores of the Motor Evaluation Scale for Upper Extremity in Stroke (MESUPES) and the Stroke Impact Scale (SIS).ConclusionsThe present version of SULCS shows valid and reliable cultural adaptation, with good reliability and stability.
Highlights
Brachial hemiparesis is one of the most frequent sequelae of stroke, leading to important functional disability given the role of the upper limb in executing activities of daily living (ADL)
In the original Stroke Upper Limb Capacity Scale (SULCS) instrument there was a reference to the term “affected forearm”, which had been equivalently translated and was changed during the expert review to the Portuguese equivalent of “affected limb”
Ischaemic aetiologies represent the majority of strokes (87%, thrombotic or embolic), while haemorrhagic aetiologies represent a small fraction of cases (13%, intracerebral or subarachnoid) [24]
Summary
Brachial hemiparesis is one of the most frequent sequelae of stroke, leading to important functional disability given the role of the upper limb in executing activities of daily living (ADL). In Portugal, the mortality rate from cerebrovascular diseases decreased from 71.9 deaths per 100,000 inhabitants in 2009 to 54.6 deaths per 100,000 inhabitants in 2013 [1]. Brain lesions due to cerebrovascular diseases are, currently, one of the leading causes of disability [3]. 70% of patients that survive stroke present hemiparesis with brachial predominance in the acute phase [4], 30% of those require inpatient care during the first 3 months and, 15–30% of patients show permanent disability [5]. 70% of patients with mild to moderate paresis recover some degree of manual dexterity within the first 6 months, while patients with paresis of the limb with reduced muscle strength do not recover [6]
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