Kettle Test-A Brief Measure of Cognitive Functional Performance: Reliability and Validity in Stroke Rehabilitation

Headnote

KEY WORDS

* cognition

* reproducibility of results

* stroke

* task performance and analysis

OBJECTIVES. We examined the reliability and validity of the Kettle Test, a brief performance measure based on a complex everyday task designed to tap into basic and higher level cognitive processes.

METHOD. Participants included 21 people attending stroke rehabilitation and 4 occupational therapists for the reliability analysis, 36 people at discharge from stroke rehabilitation, and 36 age-matched healthy control participants for the validity analyses. Instruments included a battery of conventional cognitive measures and functional outcomes.

RESULTS. Interrater reliability was found to be high. Stroke survivors at discharge from rehabilitation were found to require significantly more assistance on the Kettle Test than control participants (p < .000); their scores on the Kettle Test were significantly and moderately correlated with the conventional cognitive and functional outcome measures.

CONCLUSIONS. The results support the reliability and validity of the Kettle Test as a top-down measure of cognition-in-function in people at discharge from stroke rehabilitation.

Hartman-Maeir, A., Harel, H., & Katz, N. (2009). Kettle Test-A brief measure of cognitive functional performance: Reliability and validity in stroke rehabilitation. American Journal of Occupational Therapy, 64, 592-599.

People with acquired brain injury are at high risk for cognitive impairments that have a detrimental impact on occupational performance (Cicerone et al., 2005; Donnovan et al., 2008; Hershkovitz & Brill, 2007; Zinn et al., 2004). Occupational therapy has developed a unique body of knowledge regarding the relationship between cognition and occupation involving occupation-based, client-centered intervention (Gillen, 2009; Katz, 2005). Conventional "tabletop" measures of cognition are valuable diagnostically but have limited ecological validity and do not fully address the functional implications of cognitive deficits. Moreover, the interdisciplinary rehabilitation community has emphasized the need for ecologically valid measures of cognition in function (Burgess et al., 2006). This current emphasis is an important milestone in the conceptualization of measurement in health-related professions. Instruments that follow these directives are essential and are integral to the occupational therapy philosophy and practice (American Occupational Therapy Association, 2008). Occupational therapy is in a unique position to fulfill a central role in this development and is establishing its expertise in the development of top-down assessments (Hartman-Maeir, Katz, & Baum, 2009; Law, Baum, & Dunn, 2005).

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