Assessing upper limb function: the Spanish version of the Stroke Upper Limb Capacity Scale (SULCS): cross-cultural adaptation and clinimetric properties

Abstract

Background More than 70% of stroke survivors suffer from upper extremity paresis, which limits the ability to perform activities of daily living. To guide rehabilitation, specific tools that accurately evaluate upper limb function are essential. The Stroke Upper Limb Capacity Scale (SULCS) is a stroke-specific assessment tool that evaluates functional capacity of the upper limb. It is quick to administer, requires no specialized equipment, and is a cost-effective option for routine clinical use. Objective The aims of this study were to adapt the SULCS transculturally to Spanish and to examine its clinimetric properties. Methods For cross-cultural adaptation to Spanish, we employed a "translation/back-translation" approach and evaluated its feasibility in routine neurorehabilitation. A multicenter study was conducted in Spanish post-stroke patients (n = 56) to validate the clinimetric properties of the instrument. Results The translation into Spanish was completed without major difficulties. Reliability analysis, including test–retest and inter-operator, demonstrated almost perfect agreement for the Spanish SULCS, with weighted Cohen’s kappa values of 0.8755 (95% CI: 0.5991–1.1519) and 0.8988 (95% CI: 0.7343–1.0632) respectively. The minimal detectable change indicated high sensitivity (0.72 at the 95% confidence level). The SULCS showed excellent concurrent validity with the Fugl-Meyer Assessment (r = 0.9533), the Action Research Arm Test (r = 0.9730), and the Box and Block Test (r = 0.9247). No floor or ceiling effects were observed. Conclusions The Spanish version of the SULCS presented excellent clinimetric properties. Its characteristics make it a use ful tool for assessing upper limb functional capacity in the Spanish post-stroke population.