Italian translation, cultural adaptation, and validation of the Action Research Arm Test (ARAT) and the Stroke Upper Limb Capacity Scale (SULCS) for individuals post-stroke

Purpose This study aims to culturally adapt and validate the Stroke Upper Limb Capacity Scale (SULCS) and Action Research Arm Test (ARAT) for use with post-stroke patients in Italy. Methods The original scales were translated and culturally adapted following the "Translation and Cultural Adaptation of Patient Reported Outcomes Measures – Principles of Good Practice" guidelines. We assessed internal consistency and test–retest reliability, while concurrent validity was evaluated using Pearson correlation coefficients with the Italian version of the Disability Arm Shoulder and Hand (DASH). Results A total of 56 participants were recruited for the study. The Italian versions of the scales demonstrated excellent stability and reliability both within and between raters. The Cronbach's alpha coefficients were 0.904 for SULCS and 0.998 for ARAT, indicating strong internal consistency among items. The interclass correlation coefficients were 0.998 (95% C.I.: 0.993–0.990) for inter-rater reliability and 0.987 (95% C.I.: 0.984–0.995) for intra-rater reliability for SULCS, and 0.998 (95% C.I.: 0.999–0.996) for inter-rater reliability and 0.992 (95% C.I.: 0.998–0.987) for intra-rater reliability for ARAT. Conclusions Both scales exhibit robust validity and reliability, making them valuable tools for clinical assessment and functional evaluation of upper limb capacity in post-stroke patients. We recommend the integration of the ARAT and SULCS into initial patient assessments and ongoing monitoring to enhance rehabilitation outcomes.