Development and Content Validation of START: A Modified CIMT-Based Upper Limb Rehabilitation Tool

Syazana Zahra Umardi; Samiyem; Arif Pristianto; Farid Rahman

doi:10.24843/

Authors

Syazana Zahra Umardi Physiotherapy Study Program, Faculty of Health Sciences, Muhammadiyah University of Surakarta, Surakarta, Indonesia Author
Samiyem Physiotherapy Study Program, Faculty of Health Sciences, Muhammadiyah University of Surakarta, Surakarta, Indonesia Author
Arif Pristianto Physiotherapy Study Program, Faculty of Health Sciences, Muhammadiyah University of Surakarta, Surakarta, Indonesia Author
Farid Rahman Physiotherapy Study Program, Faculty of Health Sciences, Muhammadiyah University of Surakarta, Surakarta, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Stroke, Rehabilitation, Upper Extremity, Physical Therapy Modalities, Activities of Daily Living, Equipment Design

Abstract

Background: Stroke frequently causes upper limb dysfunction, resulting in reduced independence and limitations in activities of daily living. Accessible rehabilitation devices integrating motor and sensory training remain limited, particularly for home-based use.

Objective: To develop and evaluate the content validity of the Stroke Therapy Assistance and Recovery Tools (START), a modified Constraint-Induced Movement Therapy (m-CIMT)-based rehabilitation device for post-stroke upper limb recovery.

Methods: This Research and Development study followed the Sugiyono framework up to the design validation stage (Technology Readiness Level 5). The START device integrated strength, coordination, and sensory training components. Content validity was assessed independently by two physiotherapy experts using the Content Validity Index (CVI). Outcomes included Item-Level CVI (I-CVI), Scale-Level CVI Average (S-CVI/Ave), and Scale-Level CVI Universal Agreement (S-CVI/UA). Descriptive analysis was performed.

Results: The START device demonstrated high content validity, with an S-CVI/Ave of 0.90 and an S-CVI/UA of 0.80. Most assessment items achieved perfect agreement (I-CVI = 1.00), while two items showed partial agreement (I-CVI = 0.50). Experts recommended reducing device weight, improving ergonomic features, enhancing material durability, and incorporating automatic random light activation.

Conclusion: START demonstrated excellent content validity and feasibility as a low-cost upper limb rehabilitation tool for post-stroke individuals. The integration of strength, coordination, and sensory training supports its potential application in home-based rehabilitation. Further prototype refinement and clinical effectiveness testing are recommended.