Reliability and Concurrent Validity of the Motor Evaluation Scale for Upper Extremity in People With Chronic Stroke

Objective: To evaluate the reliability and concurrent validity of the Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and establish a cut-off score distinguishing people with chronic stroke from healthy older adults.Methods: This cross-sectional study included 64 individuals with chronic stroke and 31 healthy older adults at a university-based rehabilitation center. Assessments included MESUPES, Fugl-Meyer Assessment for Upper Extremity (FMA-UE), muscle strength and stiffness, wrist range of motion, Action Research Arm Test (ARAT), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), and Oxford Participation and Activities Questionnaire.Results: MESUPES total scores demonstrated excellent inter-rater (intraclass correlation coefficient [ICC]=0.976; 95% confidence interval [CI]: 0.960–0.985) and test–retest reliability (ICC=0.965; 95% CI: 0.943–0.978). A ceiling effect, but no floor effect, was observed; sensitivity analyses confirmed that excellent reliability was not solely attributable to ceiling effects. MESUPES scores correlated with FMA-UE (r=0.872–0.922), ARAT (r=0.821–0.885), affected elbow strength (r=0.585–0.661), wrist range of motion (dorsal–palmar: r=0.727–0.751; ulnar–radial: r=0.750–0.817), handgrip strength (r=0.674–0.783), and QuickDASH (r=-0.433 to -0.521; all p<0.001). A cut-off score of 57.5 differentiated participants with stroke from healthy older adults, with 93.5% sensitivity and 82.8% specificity.Conclusion: MESUPES demonstrated excellent reliability and concurrent validity for assessing upper-limb movement quality in chronic stroke. The cut-off score of 57.5 discriminated between participants with stroke and healthy older adults. Associations with established impairment- and activity-level measures support its use as a complementary assessment in chronic stroke rehabilitation.