Construction of the Mobility to Participation Assessment Scale for Stroke (MPASS) and Testing Its Validity and Reliability in Persons With Stroke in Thailand (original) (raw)
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Comparison of Psychometric Properties of Three Mobility Measures for Patients With Stroke
Stroke, 2003
Background and Purpose-This study compared the validity, responsiveness, and interrater reliability of 3 mobility measures in stroke patients from the acute stage up to 180 days after stroke onset. The 3 measures were the Rivermead Mobility Index (RMI), a modified RMI (MRMI), and the Mobility Subscale of the Stroke Rehabilitation Assessment of Movement (STREAM). Methods-The validity and responsiveness of the 3 mobility measures were prospectively examined by monitoring 57 stroke patients with the measures and the Barthel Index at 14, 30, 90, and 180 days after stroke onset. Two individual raters used the 3 measures to evaluate a different sample of 40 patients on 2 separate occasions to determine the interrater reliability. Results-The Spearman between STREAM and MRMI was Ն0.92; the intraclass correlation coefficient (ICC, a measure of agreement) between them was Ն0.89, indicating high concurrent validity of both measures. RMI showed a moderate to high relationship and agreement with STREAM and MRMI (Ն0.78, ICCՆ0.5). Responsiveness of the 3 measures was high before 90 days after stroke onset (standardized response mean Ն0.83) and low at 90 to 180 days after stroke onset (0.2Յstandardized response meanՅ0.4). The score changes of the 3 measures at each stage were significant (PՅ0.05), except for RMI and MRMI at 90 to 180 days after stroke onset. The interrater agreement of the 3 measures was high (ICCՆ0.92). Conclusions-All 3 measures examined showed acceptable levels of reliability, validity, and responsiveness in stroke patients. The psychometric characteristics of STREAM were slightly superior to those of the other 2 measures among our patients. We prefer and recommend STREAM for measuring mobility disability in stroke patients. (Stroke. 2003; 34:1741-1745.)
Physiotherapy, 2004
The Modified Rivermead Mobility Index (MRMI) is a newly developed outcome measure that aims to evaluate the effectiveness of physiotherapy on mobility following stroke. Any new measurement tool requires extensive testing of its validity and reliability before it can be recommended for use in clinical practice or research. The purpose of this study was to investigate the concurrent validity of the MRMI when measuring mobility in patients who have had a stroke. The internal consistency and test administration times of the MRMI and Motor Assessment Scale (MAS) were also investigated. Methods Twenty-six hospitalised acute/sub-acute stroke patients from the Medical and Elderly wards of a General Hospital in West Yorkshire were assessed independently with the MRMI and MAS. Test administration time was also recorded. Results Limits of agreement indicated that on average subjects scored three points higher on the MRMI than the MAS (mobility-related items). Ninety-five percent of subjects scored between one point lower and seven points higher on the MRMI than the MAS. Both scales possessed high internal consistency (MRMI α = 0.949 and MAS α = 0.953). Individual items also possessed high internal consistency (MRMI α = 0.743-0.959, MAS = 0.854-0.893) except the sitting balance items (MRMI α = 0.304 and MAS α = 0.545). Both scales took an average of 17 min to administer. Conclusions The mean difference between scores on the MRMI and MAS was small enough to allow clinicians to use either scale to measure mobility in stroke patients. Both scales possessed high internal consistency except the sitting balance items that may be measuring a different construct to mobility. The MRMI and MAS are sufficiently quick to administer to advocate use in routine clinical practice.
Journal of Rehabilitation Medicine
After stroke, many persons perceive difficulties in resuming meaningful activities, social relations and being in control of their own lives. To address participation restrictions is therefore important in stroke rehabilitation. The Participation domain of the Stroke Impact Scale, SIS Participation, is commonly used to assess perceived restrictions in participation after stroke. The domain includes 8 items: impact of stroke on work; social activities; quiet recreations; active recreations; role as a family member and/or friend; religious or spiritual activities; ability of life control and ability to help others. This study shows that the SIS Participation domain is reliable and can be used to assess perceived participation after stroke. Objective: To evaluate the test-retest reliability and variability of the Participation domain of the Stroke Impact Scale (SIS Participation) in persons with stroke as it is widely used to assess perceived participation in rehabilitation after stroke. Design: A test-retest design. Subjects: Forty-five persons (mean age 65 years) with mild to moderate disability at least 6 months post-stroke. Methods: The SIS Participation domain was rated on 2 occasions, 1 week apart. The test-retest reliability of the total score was evaluated using Kappa statistics. The 8 item scores were evaluated by the proportion of participants who rated the same score (percentage agreement, PA) or ± 1 point (PA ≤ 1 point) at T1 and T2. The Svensson method was used to evaluate systematic and random disagreement. Results: The test-retest reliability of the total score showed excellent agreement (Kappa coefficient = 0.79). The items showed high PA ≤ 1 point (> 82%). No items, except 2, showed a systematic disagreement, and no items showed a random disagreement according to the Svensson method. Conclusion: The SIS Participation domain is reliable in persons with chronic stroke and mild to moderate disability and can be used to assess perceived participation in this population.
Reliability and validity of the de Morton Mobility Index in individuals with sub-acute stroke
Disability and Rehabilitation, 2018
Purpose: To establish the validity and reliability of the de Morton Mobility Index (DEMMI) in patients with sub-acute stroke. Methods: This cross-sectional study was performed in a neurological rehabilitation hospital. We assessed unidimensionality, construct validity, internal consistency reliability, inter-rater reliability, minimal detectable change and possible floor and ceiling effects of the DEMMI in adult patients with sub-acute stroke. Results: The study included a total sample of 121 patients with sub-acute stroke. We analysed validity (n ¼ 109) and reliability (n ¼ 51) in two sub-samples. Rasch analysis indicated unidimensionality with an overall fit to the model (chi-square = 12.37, p ¼ 0.577). All hypotheses on construct validity were confirmed. Internal consistency reliability (Cronbach's alpha = 0.94) and inter-rater reliability (intraclass correlation coefficient = 0.95; 95% confidence interval: 0.92-0.97) were excellent. The minimal detectable change with 90% confidence was 13 points. No floor or ceiling effects were evident. Conclusions: These results indicate unidimensionality, sufficient internal consistency reliability, inter-rater reliability, and construct validity of the DEMMI in patients with a sub-acute stroke. Advantages of the DEMMI in clinical application are the short administration time, no need for special equipment and interval level data. The de Morton Mobility Index, therefore, may be a useful performance-based bedside test to measure mobility in individuals with a sub-acute stroke across the whole mobility spectrum. ä IMPLICATIONS FOR REHABILITATION The de Morton Mobility Index (DEMMI) is an unidimensional measurement instrument of mobility in individuals with sub-acute stroke. The DEMMI has excellent internal consistency and inter-rater reliability, and sufficient construct validity. The minimal detectable change of the DEMMI with 90% confidence in stroke rehabilitation is 13 points. The lack of any floor or ceiling effects on hospital admission indicates applicability across the whole mobility spectrum of patients with sub-acute stroke.
Journal of Rehabilitation Medicine, 2002
The Stroke Rehabilitation Assessment of Movement (STREAM) instrument is used to measure motor and mobility problems in patients who have experienced a stroke. The purposes of the study were to examine the interrater reliability, concurrent and convergent validity of the STREAM instrument in stroke patients. Fifty-four stroke patients participated in the study. For the purpose of interrater reliability, the STREAM instrument was administered by two raters on each patient within a 2-day period. Validity was assessed by comparing the patients' scores on the STREAM instrument with those obtained from the other well-established measures. Weighted kappa statistics for inter-rater agreement on scores for individual items ranged from 0.55 to 0.94. The intraclass correlation coefficient for the total score was 0.96 indicating very high inter-rater reliability. The intraclass correlation coefficients were also very high in each of the subscales. The total STREAM score was moderately to highly associated with the score of the Barthel Index and Fugl-Meyer motor assessment scale, rho = 0.67, and 0.95, respectively. The STREAM subscale scores were closely associated with scores of the other well-validated measures. Our results demonstrate that consistent and valid information can be obtained from the STREAM instrument and support its use in the value of the STREAM evaluation of motor and mobility recovery in persons who have experienced a stroke.
Journal of medical technology, 2017
The extended International Classification of Functioning, Disability and Health (ICF) core set for stroke is an assessment tool for describing stroke-related health. It was applied to rehabilitation settings in a number of countriesbut there was no a report of its systematic use in Thailand. Before this core set could be used with Thai population, there was a need to investigate its quality of measurement. This study aimed to evaluate content validity of the extended ICF core set for stroke in Thai population. Participants were 43 persons with stroke (27 males and 16 females, mean age ± SD 65.6±10.6 years) who were living in a district of Surin Province. A physical therapist filled in the core set with a universal qualifying scale ranging from 0 (no problem/facilitator/barrier) to 4 (complete problem/facilitator/barrier) or the qualifiers 8 (not specified) and 9 (not applicable). The ratings were based on information obtained through interviews with the participants and their caregi...
Psychometric properties of the Rivermead Mobility Index in Italian stroke rehabilitation inpatients
Clinical …, 2003
To examine the internal consistency, validity, responsiveness and test scalability of the Rivermead Mobility Index (RMI) in Italian rehabilitation inpatients recovering from stroke. Design: Seventy-three stroke inpatients undergoing rehabilitation were assessed at admission (T 0) and ve weeks later (T 1), using RMI, the motor (motFIM) and cognitive (cognFIM) subscales of the Functional Independence Measure, the 'leg' section of the Motricity Index and Trunk Control Test. Results: Cronbach's alpha of the RMI was 0.92. The item-to-total correlation coef cients (r rb) ranged from 0.36 to 0.83, all p < 0.003. All correlations between RMI scores and the other instruments, both at T 0 and T 1 , were statistically signi cant (r 0.49, all p < 0.0001), except those with cognFIM. The difference in RMI scores over the testing period was statistically signi cant (sign test: z = 7.1, p < 0.0001) and the effect size was 0.89. The coef cient of reproducibility was 0.95 at T 0 and 0.93 at T 1 , and both coef cients of scalability were 0.67. Conclusions: The study con rms the internal consistency, construct validity and responsiveness of the RMI, according to the classic psychometric indexes. However, some minor concerns arise regarding: (a) a oor effect of RMI in subacute rehabilitation stroke inpatients at admission and; (b) one item ('bathing') that seems sensitive to cultural and environmental factors. Moreover, even though RMI met the scaling criteria, the item hierarchy is not coincident with the one originally postulated. So, RMI should be considered only as a summated index with ordinal properties, and not a hierarchically ranked scale.
Journal of Physical Therapy Science, 2015
Purpose] This study aimed to identify the International Classification of Functioning, Disability, and Health categories addressed by the assessment tools commonly used in post-stroke rehabilitation and characterize patients based on its evaluation model. [Subjects and Methods] An exploratory, descriptive, cross-sectional study was conducted involving 35 individuals with chronic post-stroke hemiparesis. Handgrip strength was assessed to evaluate body functions and structures. The 10-meter gait speed test and Timed Up and Go test were administered to evaluate activity. The Stroke Specific Quality of Life scale was used to evaluate participation. Moreover, a systematic review of the literature was performed to identify studies that have associated these assessment tools with the International Classification of Functioning, Disability, and Health categories.
Physical Therapy, 2017
Background. The Motor Activity Log (MAL) and Lower-Functioning MAL (LF-MAL) are used to assess the amount of use of the more impaired arm and the quality of movement during activities in real-life situations for patients with stroke. Objective. This study used Rasch analysis to examine the psychometric properties of the MAL and LF-MAL in patients with stroke. Design. This is a methodological study. Methods. The MAL and LF-MAL include 2 scales: the amount of use (AOU) and the quality of movement (QOM). Rasch analysis was used to examine the unidimensionality, item difficulty hierarchy, targeting, reliability, and differential item functioning (DIF) of the MAL and LF-MAL. Results. A total of 403 patients with mild or moderate stroke completed the MAL, and 134 patients with moderate/severe stroke finished the LF-MAL. Evidence of disordered thresholds and poor model fit were found both in the MAL and LF-MAL. After the rating categories were collapsed and misfit items were deleted, all items of the revised MAL and LF-MAL exhibited ordering and constituted unidimensional constructs. The person-item map showed that these assessments were difficult for our participants. The person reliability coefficients of these assessments ranged from .79 to .87. No items in the revised MAL and LF-MAL exhibited bias related to patients' characteristics. Limitations. One limitation is the recruited patients, who have relatively highfunctioning ability in the LF-MAL. Conclusions. The revised MAL and LF-MAL are unidimensional scales and have good reliability. The categories function well, and responses to all items in these assessments are not biased by patients' characteristics. However, the revised MAL and LF-MAL both showed floor effect. Further study might add easy items for assessing the performance of activity in real-life situations for patients with stroke.
Developing a short form of the postural assessment scale for people with stroke
2007
Objective: To develop a Short Form of Postural Assessment Scale for Stroke patients (SFPASS) with sound psychometric properties (including reliability, validity, and responsiveness). Methods. This study consisted of 2 parts: developing the SFPASS and cross-validation. In the 1st part, 287 people with stroke were evaluated with the PASS at 14-and 30-day post-stroke intervals.