Objective: This study aims to carry out validity and reliability of the Test dEvaluation des Membres Superieurs Des Personnes Agees (TEMPA) in patients with PD.

Background: There is no a specific tool to assess functional aspects of the upper limb (UL) in patients with PD. TEMPA is a tool used in other neurological diseases to assess Activity domain of UL. TEMPA contains unilateral and bilateral tasks that are representative of daily living activities including both quantitative and qualitative parameters.

Methods: The following psychometric properties of the TEMPA were evaluated in 52 subjects: inter-rater and test-retest reliability; concurrent validity assessed by the correlation of the TEMPA with sections (II, III) of the UPDRS; convergent validity, between correlation of TEMPA and Nine HolePeg Test (NHPT); discriminant validity, verified by comparing the TEMPA and Hoehn and Yahr scale. For the reliabilities evaluation was used the intraclass correlation coefficient (ICC) with confidence intervals (CI) of 95%, considering: weak agreement (ICC<0.40); moderate agreement (CCI≤0.75); and excellent agreement (ICC>0.75). The weighted kappa (Wk) was used to assess inter-rater agreement of TEMPA, for individual items and for the total score. The agreement was considered excellent for Wk values between 0.81-1.00; substantial, 0.61 to 0.80; moderate, 0.41 to 0.60; fair, 0.21 to 0.40; poor, 0-0.20, and with no agreement when equal to zero. Internal consistency was established using the Cronbach’s alpha, adopting a value from 0.70 to 0.90 for achieve a good agreement between the scale items. To analyze the discriminant validity, oneway ANOVA was used. Convergent and concurrent validity were determined by nonparametric Spearman correlation.

Results: Excellent reliability and inter-rater agreement (intraclass correlation coefficient – ICC=0.99 and weighted kappa – k=0.92)

The inter-rater reliability for the TEMPA total score, execution speed, functional and task analysis total scores

N=52	Rater 1 Median (mini –maxi)	Rater 1 Means ± SD	Rater 2 Median (mini – maxi)	Rater 2 Means ± SD	ICC (CI 95%)	Wk (CI 95%)
Total Score	10.5 (1 – 58)	14.6 (13.3)	10 (1 – 57)	15 (13.7)	0.99 (0.98 – 0.99)	0.92 (0.89 – 0.94)
Speed of execution	236.4 (141 -531)	252.9 (87.6)	231.1 (138 – 527)	245.5 (81.9)	0.98 (0.97- 0.99)	0.91 (0.87 – 0.95)
Functional Rating	2 (0 – 14)	3.34 (3.24)	2 (0 – 14)	3.0 (3.1)	0.97 (0.96 – 0.98)	0.88 (0.81 – 0.95)
Task analysis	8 (1 – 44)	11.2 (10.2)	8.5 (0 – 43)	12 (10.8)	0.98 (0.97 – 0.99)	0.89 (0.85 – 0.93)

ICC= intraclass correlation coefficient: CI= confidence intervals Wk weighted kappa;SD= standard deviation” and test-retest reliability (ICC=0.97)

The test-retest reliability for the TEMPA total score, execution speed, functional rating and task analysis total scores

N=25, Florianopolis	Rater 1 Median (mini – max.)	Rater 1 Means ± SD	ICC – (CI 95 %)
Total Score	14 (1- 57)	15.7 (13.8)	0.97 (0.95 – 0.99)
Speed of execution	247.5 (138.6 – 548.1)	259 (93.8)	0.89 (0.7 – 0.97)
Functional rating	2 (0 – 13)	3.5 (2.6)	0.97 (0.94 – 0.98)
Task analysis	12 (1 – 57)	12.3 (10.4)	0.95 (0.94 – 0.98)
N=27, Rio de Janeiro	Rater 2 Median (mini – maxi.)	Rater 2 Means ± SD	ICC- (CI 95 %)
Total Score	8 (1- 48)	13.1 (12.9)	0.99 (0.99 – 1)
Speed of execution	191.1 (109.7 – 370.6)	200.9 (59.4)	0.69 (0.42 – 0.85)
Functional rating	2 (0 – 10)	2.7 (2.8)	0.98 (0.95 – 0.99)
Task analysis	6 (1 – 38)	10.4 (10.4)	0.99 (0.99 – 1)

ICC= intraclass correlation coefficient: CI= confidence intervals Wk weighted kappa;SD= standard deviation” for TEMPA. It was found a negative moderate correlation between the TEMPA and section II of the UPDRS (ρ=-0.58; p=0.000), moderate correlations between the test and NHPT values of the right and left UL (ρ=0.56 and ρ=0.41; p=0.000) (ρ=0.52 and ρ=0.51; p=0.000 and p=0.002), respectively. There was no significant relationship between the group that presented freezing episodes (p=0.057).

Conclusions: TEMPA showed adequate psychometric properties in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/validity-and-reliability-of-the-test-d-evaluation-des-membres-superieurs-de-personnes-agees-tempa-to-assess-upper-limb-in-parkinsons-disease/