Use of the Halstead Category Test as a cognitive predictor of functional recovery in the hemiplegic upper limb: A cross-validation study

Current motor learning theory suggests that recovery in the hemiplegic upper limb partially depends on the client's cognitive ability to maximize sensory feedback in order to activate appropriate efferent motor pathways. Study 1 investigated the use of the Category Test as a predictor of functional recovery. Initial scores on the Upper Extremity Function Test and the Category Test explained 81% of the variance of the discharge Upper Extremity Function score (N = 29). Psychological factors such as the client's attitude and motivation were less significant than more direct measures of the biological event. Study 2 (N = 16) confirmed these results and also found that stroke survivors who made fewer errors on the Category Test performed better on a functional disability test. Survivors making the fewest errors on the Category Test also showed the greatest amount of change in arm and hand function. The results are discussed in terms of the role of cognitive and biological factors that might influence recovery.