Arm Activity Measure

Original Editor - Mohamed Hassanin Top Contributors - Mohamed A Hassanin and Carina Therese Magtibay

Introduction[edit | edit source]

Arm Activity Measure (ArmA) is a measure in form of questionnaire to examine both active and passive motor functions among spastic patients. The two parts are separate . The ArmA evaluates spasticity intervention (often for passive function) and other focal rehabilitation interventions such as task practice training for active function improvement.[1]

Description[edit | edit source]

It is a 20-item questionnaire of difficulty in passive and active hemiparetic arm function can be filled by the patient or the care person. The care person can write your responses for you or help you understand and complete the questionnaire, or respond to the questions on your behalf.

For each of the activities listed in the ArmA, the person completing the measure needs to indicate:

  • The amount of difficulty that you or your carer/caregiver experience in doing the task, based on your activity over the last seven days. Please estimate if you do the task but have not done so in the last seven days (e.g. for cutting fingernails).
  • If the task is never done, but this has nothing to do with your arm or is never done with your affected arm, the score should be 0 = No difficulty.[2]

Categories of the measure[edit | edit source]

It consists of a seven-item passive function subscale, and 13-item active function subscale in form of two sections: A (Passive function) and B (Active function).

Section A is about caring for your affected arm (by yourself or a carer/caregiver or a combination).  The section does not ask about using your affected arm to complete any of the tasks. It includes tasks such as cleaning palm also armpit and elbow crease, cutting nails, arm positioning or support in sitting and putting on an arm garment (sleeve) or glove or splint.[3]

Section B asks what you can do using your affected arm or using both arms together (Unilateral and bilateral functional activities)[3]. The tasks included are:

  1. Losing balance on walking due to affected arm.
  2. Hold an object in its position while using the non affected hand
  3. Opening a previously opened jar.
  4. Pick up an object e.g. glass.
  5. Drink from a cup.
  6. Teeth Brushing.
  7. Shirt Tucking.
  8. Writing.
  9. Eating with a fork and knife.
  10. Dialling on a home phone.
  11. Do Buttoning for worn clothing.
  12. Combing or hair brushing.
  13. Use a key to open door.

Rating[edit | edit source]

Using a Likert scoring system between 0 (no difficulty) and 4 (unable to do task). [2]

  • 0 = No difficulty
  • 1 = Mild difficulty
  • 2 = Moderate difficulty
  • 3 = Severe difficulty
  • 4 = Unable to do activity

The passive function subscale scores range from 0 (high function) to 28 and the active function subscale scores range from 0 (high function) to 52.

Reliability & Validity[edit | edit source]

ArmA was shown to be a reliable and valid self-report questionnaire for use in clinical practice and research to assess improvements in passive and active upper limb function in patients with disabling spasticity[1] [4].

Translations[edit | edit source]

Resources[edit | edit source]

You can get a free copy from the questionnaire from here.

References[edit | edit source]

  1. 1.0 1.1 Ashford S, Slade M, Turner-Stokes L. Conceptualisation and development of the arm activity measure (ArmA) for assessment of activity in the hemiparetic arm. Disability and Rehabilitation. 2013 Jan 7;35(18):1513–8.
  2. 2.0 2.1 Arm Activity measure (ArmA) | Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation | King’s College London [Internet]. [cited 2024 Mar 30]. Available from:
  3. 3.0 3.1 Ashford S, Slade M, Nair A, Turner-Stokes L, Ashford S. Arm Activity measure (ArmA) application for recording functional gain following focal spasticity treatment. International Journal of Therapy and Rehabilitation. 2015 Jan;21(1):10-17. Epub 2014 Apr 20. doi: 10.12968/ijtr.2014.21.1.10
  4. 4.0 4.1 Ramström T, Bunketorp-Käll L, Wangdell J. Arm activity measure (ArmA): psychometric evaluation of the Swedish version. Journal of Patient-Reported Outcomes. 2021 May 12;5(1).
  5. Buntragulpoontawee M, Khunachiva J, Euawongyarti P, Wongpakaran N, Wongpakaran T, Kaewma A, et al. Investigating psychometric properties of the arm activity measure – Thai version (ArmA-TH) sub‐scales using the Rasch model. BMC Medical Research Methodology. 2021 Mar 9;21(1).