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Wang YC, Chang PF, Chen YM, Lee YC, Huang SL, Chen MH, Hsieh CL. Comparison of responsiveness of the Barthel Index and modified Barthel Index in patients with stroke. Disabil Rehabil 2023; 45:1097-1102. [PMID: 35357990 DOI: 10.1080/09638288.2022.2055166] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare the group- and individual-level responsiveness of the Barthel Index (BI) and modified BI (MBI) in patients with early subacute stroke. MATERIALS AND METHODS The BI and MBI scores of 63, 63, and 55 patients were retrieved at 3 time points with a 3-weeks interval. The group-level responsiveness was examined using paired t-test and standardized response mean (SRM). The individual-level responsiveness was examined by the percentage of patients who achieved significant improvement exceeding the corresponding minimal detectable change. RESULTS At the group level, the MBI showed significantly larger SRMs than did the BI in the 1st-2nd assessment (1.10 vs. 0.81 [95% CI of mean difference = 0.05-0.38]) and the 2nd-3rd assessment (0.94 vs. 0.72 [95% CI of mean difference = 0.04-0.41]). At the individual level, the MBI detected significantly more patients with significant improvement than the BI for the 1st-2nd assessments only (34.9 vs. 25.4% [95% CI of mean differences = 3.2-17.5]). CONCLUSIONS The MBI has better responsiveness than the BI at both the group and individual levels in the patients with early subacute stroke. The MBI is recommended for clinical and research use as an outcome measure for patients with stroke.IMPLICATIONS FOR REHABILITATIONThe MBI is recommended for clinical and research applications because of its superior ability to detect subtle changes in ADL performance in patients with subacute stroke.The MBI and the BI have equal responsiveness for patients whose magnitude of improvement of ADL is substantial.
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Affiliation(s)
- Yi-Ching Wang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Pei-Fen Chang
- School of Occupational Therapy, Texas Woman's University, Houston, TX, USA
| | - Yi-Miau Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ya-Chen Lee
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Sheau-Ling Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Mei-Hsiang Chen
- Department of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan
- Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
- Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Aloraini SM, Abu Mismar AA, Aloqaily HF, Aldaihan MM. Balance assessment tools and their psychometric properties among individuals post-stroke: a systematic review. PHYSICAL THERAPY REVIEWS 2023. [DOI: 10.1080/10833196.2023.2168850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- Saleh M. Aloraini
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Arwa A. Abu Mismar
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Haifa F. Aloqaily
- Department of Physical Therapy, College of Medical Rehabilitation, Qassim University, Saudi Arabia
| | - Mishal M. Aldaihan
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Wang I, Li PC, Lee SC, Lee YC, Wang CH, Hsieh CL. Development of a Berg Balance Scale Short-Form Using a Machine Learning Approach in Patients With Stroke. J Neurol Phys Ther 2023; 47:44-51. [PMID: 36047823 DOI: 10.1097/npt.0000000000000417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND AND PURPOSE The Berg Balance Scale (BBS) is frequently used in routine clinical care and research settings and has good psychometric properties. This study was conducted to develop a short form of the BBS using a machine learning approach (BBS-ML). METHODS Data of 408 individuals poststroke were extracted from a published database. The initial (ie, 4-, 5-, 6-, 7-, and 8-item) versions were constructed by selecting top-ranked items based on the feature selection algorithm in the artificial neural network model. The final version of the BBS-ML was chosen by selecting the short form that used a smaller number of items to achieve a higher predictive power R2 , a lower 95% limit of agreement (LoA), and an adequate possible scoring point (PSP). An independent sample of 226 persons with stroke was used for external validation. RESULTS The R2 values for the initial 4-, 5-, 6-, 7-, and 8-item short forms were 0.93, 0.95, 0.97, 0.97, and 0.97, respectively. The 95% LoAs were 14.2, 12.2, 9.7, 9.6, and 8.9, respectively. The PSPs were 25, 35, 34, 35, and 36, respectively. The 6-item version was selected as the final BBS-ML. Preliminary external validation supported its performance in an independent sample of persons with stroke ( R2 = 0.99, LoA = 10.6, PSP = 37). DISCUSSION AND CONCLUSIONS The BBS-ML seems to be a promising short-form alternative to improve administrative efficiency. Future research is needed to examine the psychometric properties and clinical usage of the 6-item BBS-ML in various settings and samples.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A402 ).
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Affiliation(s)
- Inga Wang
- Department of Rehabilitation Sciences & Technology (I.W.), University of Wisconsin-Milwaukee, Milwaukee, Wisconsin; School of Occupational Therapy (P.-C.L., S.-C.L., C.-L.H.), College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Occupational Therapy (S.-C.L.), College of Medicine, National Cheng Kung University, Tainan City, Taiwan; Department of Occupational Therapy (Y.-C.L., C.-L.H.), College of Medical and Health Science, Asia University, Taichung, Taiwan; Institute of Long-Term Care (S.-C.L.), MacKay Medical College, New Taipei City, Taiwan; Department of Physical Therapy (C.-H.W.) and Physical Therapy Room (C.-H.W.), Chung Shan Medical University Hospital, Taichung, Taiwan; and Department of Physical Medicine and Rehabilitation (C.-L.H.), National Taiwan University Hospital, Taipei, Taiwan
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Nascimento LR, Rocha RJ, Boening A, Ferreira GP, Perovano MC. Home-based exercises are as effective as equivalent doses of centre-based exercises for improving walking speed and balance after stroke: a systematic review. J Physiother 2022; 68:174-181. [PMID: 35753966 DOI: 10.1016/j.jphys.2022.05.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 03/18/2022] [Accepted: 05/30/2022] [Indexed: 11/26/2022] Open
Abstract
QUESTIONS In people who have had a stroke, how comparable are the effects of home-based exercises with those of equivalent centre-based exercises for improving walking speed, balance, mobility and participation? Is the comparability of the effects of these two types of exercise maintained beyond the intervention period? DESIGN Systematic review of randomised controlled trials. SEARCH STRATEGY Searches were conducted on MEDLINE, AMED, EMBASE, Cochrane, PsycINFO and PEDro databases, without date or language restrictions. PARTICIPANTS Participants in the reviewed studies were ambulatory adults at any time after stroke. INTERVENTIONS The experimental intervention consisted of home-based exercises, which was compared with equivalent doses of centre-based exercises. OUTCOME MEASURES Walking speed, balance, mobility and participation. DATA ANALYSIS The quality of included trials was assessed using the PEDro scores. Outcome data were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of evidence was determined according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. RESULTS Nine trials involving 609 participants were included. Random-effects meta-analyses provided high-quality evidence that home-based and centre-based exercises provide similar effects on walking speed (MD -0.03 m/s, 95% CI -0.07 to 0.02) and balance (MD 0 points, 95% CI -1 to 2). Results regarding mobility (SMD -0.4, 95% CI -1.3 to 0.4) and participation (MD -5 points, 95% CI -19 to 10) were imprecise. For most outcomes, the effects of home-based exercises and centre-based exercises remained similar beyond the intervention period. CONCLUSION Effects of home-based prescribed exercises on walking speed, balance, mobility and participation are likely to be similar to improvements obtained by equivalent doses of centre-based exercises after stroke. REVIEW REGISTRATION PROSPERO (CRD42021254642).
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Affiliation(s)
- Lucas R Nascimento
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil.
| | - Rafaela Js Rocha
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil
| | - Augusto Boening
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil
| | - Gabriel P Ferreira
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil
| | - Mikaella C Perovano
- Center of Health Sciences, Discipline of Physiotherapy, Universidade Federal do Espírito Santo, Brazil
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Yu L, Zhao Y, Wang H, Sun TL, Murphy TE, Tsui KL. Assessing elderly's functional balance and mobility via analyzing data from waist-mounted tri-axial wearable accelerometers in timed up and go tests. BMC Med Inform Decis Mak 2021; 21:108. [PMID: 33766011 PMCID: PMC7995592 DOI: 10.1186/s12911-021-01463-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 03/07/2021] [Indexed: 11/18/2022] Open
Abstract
Background Poor balance has been cited as one of the key causal factors of falls. Timely detection of balance impairment can help identify the elderly prone to falls and also trigger early interventions to prevent them. The goal of this study was to develop a surrogate approach for assessing elderly’s functional balance based on Short Form Berg Balance Scale (SFBBS) score. Methods Data were collected from a waist-mounted tri-axial accelerometer while participants performed a timed up and go test. Clinically relevant variables were extracted from the segmented accelerometer signals for fitting SFBBS predictive models. Regularized regression together with random-shuffle-split cross-validation was used to facilitate the development of the predictive models for automatic balance estimation. Results Eighty-five community-dwelling older adults (72.12 ± 6.99 year) participated in our study. Our results demonstrated that combined clinical and sensor-based variables, together with regularized regression and cross-validation, achieved moderate-high predictive accuracy of SFBBS scores (mean MAE = 2.01 and mean RMSE = 2.55). Step length, gender, gait speed and linear acceleration variables describe the motor coordination were identified as significantly contributed variables of balance estimation. The predictive model also showed moderate-high discriminations in classifying the risk levels in the performance of three balance assessment motions in terms of AUC values of 0.72, 0.79 and 0.76 respectively. Conclusions The study presented a feasible option for quantitatively accurate, objectively measured, and unobtrusively collected functional balance assessment at the point-of-care or home environment. It also provided clinicians and elderly with stable and sensitive biomarkers for long-term monitoring of functional balance.
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Affiliation(s)
- Lisha Yu
- School of Data Science, City University of Hong Kong, Kowloon, Hong Kong
| | - Yang Zhao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Guangdong, People's Republic of China.
| | - Hailiang Wang
- School of Design, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Tien-Lung Sun
- Department of Industrial Engineering and Management, Yuan Ze University, Taoyuan, Taiwan
| | - Terrence E Murphy
- Department of Internal Medicine, Yale University School of Medicine, New Haven, USA
| | - Kwok-Leung Tsui
- Department of Industrial and Systems Engineering, Virginia Tech, Blacksburg, USA
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Nascimento LR, da Silva LA, Araújo Barcellos JVM, Teixeira-Salmela LF. Ankle-foot orthoses and continuous functional electrical stimulation improve walking speed after stroke: a systematic review and meta-analyses of randomized controlled trials. Physiotherapy 2020; 109:43-53. [PMID: 33120054 DOI: 10.1016/j.physio.2020.08.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Indexed: 10/23/2022]
Abstract
BACKGROUND Foot-drop is a common impairment after stroke, which reduces walking ability. OBJECTIVE To examine the efficacy of interventions aimed at reducing foot-drop, i.e., ankle-foot orthoses and functional electrical stimulation, on walking speed and balance after stroke. DATA SOURCES MEDLINE, EMBASE, Cochrane, PsycINFO, and PEDro databases. ELIGIBILITY CRITERIA The review included only parallel, randomized trials. Participants were ambulatory adults after stroke. The experimental interventions were the use of an ankle-foot orthosis or functional electrical stimulation. DATA SYNTHESIS Outcome data related to walking speed and balance were extracted from the eligible trials and combined in random-effects meta-analyses. The quality of trials was assessed by the PEDro scores and the quality of evidence was determined according the Grading of Recommendations Assessment, Development, and Evaluation system. RESULTS Eleven trials involving 1135 participants were included. The mean PEDro score of the trials was 5.8 (ranging from 4 to 7). Ankle-foot orthoses (MD 0.24m/s; 95% CI 0.06 to 0.41) and functional electrical stimulation (MD 0.09m/s; 95% CI 0.03 to 0.14) significantly increased walking speed, compared with no intervention/placebo. Results regarding balance were inconclusive. Ankle-foot orthoses were not superior to functional electrical stimulation for improving walking speed (MD 0.00m/s; 95% CI -0.06 to 0.05) or balance (MD 0.27 points on the Berg Balance Scale; 95% CI -0.85 to 1.39) after stroke. CONCLUSIONS This systematic review provided moderate-quality evidence that both ankle-foot orthoses and functional electrical stimulation improve walking speed after stroke, but the effects on balance remain unclear. SYSTEMATIC REVIEW REGISTRATION NUMBER PROSPERO CRD42019130988.
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Affiliation(s)
- Lucas Rodrigues Nascimento
- Center of Health Sciences, Discipline of Physical Therapy, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil; NeuroGroup, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.
| | - Layla Alvarenga da Silva
- Center of Health Sciences, Discipline of Physical Therapy, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil.
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Nascimento LR, Flores LC, de Menezes KK, Teixeira-Salmela LF. Water-based exercises for improving walking speed, balance, and strength after stroke: a systematic review with meta-analyses of randomized trials. Physiotherapy 2020; 107:100-110. [DOI: 10.1016/j.physio.2019.10.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Indexed: 11/25/2022]
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Alzyoud J, Medley A, Thompson M, Csiza L. Responsiveness, minimal detectable change, and minimal clinically important difference of the sitting balance scale and function in sitting test in people with stroke. Physiother Theory Pract 2020; 38:327-336. [PMID: 32401095 DOI: 10.1080/09593985.2020.1756016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background: Limited studies have examined the responsiveness of the Sitting Balance Scale (SBS) and Function in Sitting Test (FIST). No studies have investigated the psychometric properties of these tools in skilled nursing facilities.Objective: The purposes of the study were (1) to examine responsiveness of the SBS and FIST, in people with stroke, receiving rehabilitation in skilled nursing facilities; and (2) to estimate the MDC and MCID of these scales.Methods: Forty participants completed the FIST, SBS, and Barthel Index (BI) at admission and discharge. Internal responsiveness of the FIST and SBS was measured using Effect Size (ES) and Standardized Response Mean (SRM). Examining the association between the difference in scores on the SBS or FIST and the difference in scores on the BI determined external responsiveness. MDC and MCID were estimated for both measures.Results: The ES and the SRM for both scales were large (1.01-2.30) indicating excellent internal responsiveness. Both scales demonstrated satisfactory external responsiveness, showing good association with change in BI scores (p < .01). MDC90 of the SBS and the FIST were 2.3 and 3.9, respectively. Anchor-based MCID estimates were 4.5 and 3.5, and distribution-based were 3.5 and 4.8 for the SBS and FIST, respectively.Conclusions: Both scales demonstrate sufficient responsiveness in the skilled nursing setting. Our findings suggest a change of 5 on the SBS and 4 on the FIST are clinically important, and clinicians may use these values to assess patient progress.
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Affiliation(s)
- Jehad Alzyoud
- School of Physical Therapy, Florida Southern College, Lakeland, FL, USA
| | - Ann Medley
- School of Physical Therapy, Texas Woman's University, Dallas, TX, USA
| | - Mary Thompson
- School of Physical Therapy, Texas Woman's University, Dallas, TX, USA
| | - Linda Csiza
- American Board of Physical Therapy Residency and Fellowship Education, American Physical Therapy Association, Alexandria, VA, USA
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Huang YJ, Lin GH, Lee SC, Hsieh CL. A Comparison of the Responsiveness of the Postural Assessment Scale for Stroke and the Berg Balance Scale in Patients With Severe Balance Deficits After Stroke. J Geriatr Phys Ther 2019; 43:194-198. [PMID: 31569171 DOI: 10.1519/jpt.0000000000000247] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND AND PURPOSE Previous evidence that the Postural Assessment Scale for Stroke (PASS) and the Berg Balance Scale (BBS) have similar responsiveness is doubtful. Compared with the BBS, the PASS has more items assessing basic balance abilities (such as postural transition during lying and sitting), so it should be more likely to detect changes in patients with severe balance deficits. We aimed to compare the responsiveness of the PASS and the BBS in patients with stroke who have severe balance deficits. METHODS The PASS and BBS scores of 49 patients with severe balance deficits at 14 and 30 days after stroke were retrieved. The group-level responsiveness was examined with the standardized response mean (SRM). The individual-level responsiveness was examined by the proportion of patients who achieved clinically significant improvements (ie, their pre-post change scores in the PASS/BBS exceeded the minimal detectable change with 95% confidence of each measure). The responsiveness of the 2 measures was compared using the bootstrap approach. RESULTS AND DISCUSSION The comparisons of responsiveness showed significant differences between the PASS and the BBS at both the group and individual levels. At the group level, the PASS indicated moderate changes in balance function (SRM = 0.79), but the BBS indicated only small changes (SRM = 0.39). At the individual level, the PASS showed that 42.9% of patients had clinically significant improvements, while the BBS showed that only 6.1% of patients had clinically significant improvements. CONCLUSIONS Compared with the BBS, the PASS was better able to detect balance improvements in patients having severe balance deficits. The PASS is recommended as an outcome measure to detect change in balance in patients with stroke who have severe balance deficits.
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Affiliation(s)
- Yi-Jing Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Gong-Hong Lin
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Shih-Chieh Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.,Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Group- and Individual-Level Responsiveness of the 3-Point Berg Balance Scale and 3-Point Postural Assessment Scale for Stroke Patients. Arch Phys Med Rehabil 2017; 99:529-533. [PMID: 28899824 DOI: 10.1016/j.apmr.2017.08.472] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 08/06/2017] [Accepted: 08/14/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To examine both group- and individual-level responsiveness of the 3-point Berg Balance Scale (BBS-3P) and 3-point Postural Assessment Scale for Stroke Patients (PASS-3P) in patients with stroke, and to compare the responsiveness of both 3-point measures versus their original measures (Berg Balance Scale [BBS] and Postural Assessment Scale for Stroke Patients [PASS]) and their short forms (short-form Berg Balance Scale [SFBBS] and short-form Postural Assessment Scale for Stroke Patients [SFPASS]) and between the BBS-3P and PASS-3P. DESIGN Data were retrieved from a previous study wherein 212 patients were assessed at 14 and 30 days after stroke with the BBS and PASS. SETTING Medical center. PARTICIPANTS Patients (N=212) with first onset of stroke within 14 days before hospitalization. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Group-level responsiveness was examined by the standardized response mean (SRM), and individual-level responsiveness was examined by the proportion of patients whose change scores exceeded the minimal detectable change of each measure. The responsiveness was compared using the bootstrap approach. RESULTS The BBS-3P and PASS-3P had good group-level (SRM, .60 and SRM, .56, respectively) and individual-level (48.1% and 44.8% of the patients with significant improvement, respectively) responsiveness. Bootstrap analyses showed that the BBS-3P generally had superior responsiveness to the BBS and SFBBS, and the PASS-3P had similar responsiveness to the PASS and SFPASS. The BBS-3P and PASS-3P were equally responsive to both group and individual change. CONCLUSIONS The responsiveness of the BBS-3P and PASS-3P was comparable or superior to those of the original and short-form measures. We recommend the BBS-3P and PASS-3P as responsive outcome measures of balance for individuals with stroke.
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Waldman-Levi A, Hirsch I, Gutwillig G, Parush S. Psychometric Properties of the Parents as Partners in Intervention (PAPI) Questionnaires. Am J Occup Ther 2017; 71:7102220020p1-7102220020p8. [PMID: 28218588 DOI: 10.5014/ajot.2017.020289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This article describes two studies that focused on parents' expectations and satisfaction with occupational therapy intervention for their children (N = 208). The first study determined the psychometric properties of the Parents as Partners in Intervention (PAPI) Questionnaire set (n = 146). The 2nd study examined parental expectations, satisfaction, and perception of their child's functional gains from individual- (n = 30 parents) and group- (n = 32 parents) based interventions. Overall, the results of these studies further support the PAPI Questionnaire set's validity and reliability and suggest that parents' expectations are high and not necessarily in line with their actual satisfaction with the outcomes of their child's intervention and functional gains.
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Affiliation(s)
- Amiya Waldman-Levi
- Amiya Waldman-Levi, PhD, OTR/L, is Adjunct Lecturer, Occupational Therapy Program, School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, and Fellow Researcher, Research Institute for Health and Medical Professions, Ono Academic College, Kiryat Ono, Israel;
| | - Idit Hirsch
- Idit Hirsch, MsC, OT, is Senior Occupational Therapist, Maccabi Healthcare Services, Child Development Center, Jerusalem, Israel
| | - Galia Gutwillig
- Galia Gutwillig, MsC, OT, is Director of Occupational Therapy Services, Sharon Shomron County, Clalit Health Services, Netanya, Israel
| | - Shula Parush
- Shula Parush, PhD, OT, is Professor, School of Occupational Therapy of Hadassah and the Hebrew University, Jerusalem, Israel
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Baker KG. A cautionary fail. Physiotherapy 2016; 102:e6. [PMID: 27005517 DOI: 10.1016/j.physio.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 12/20/2015] [Indexed: 10/22/2022]
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Huang CY, Song CY, Chen KL, Chen YM, Lu WS, Hsueh IP, Hsieh CL. Validation and Establishment of an Interval-Level Measure of the Balance Assessment in Sitting and Standing Positions in Patients With Stroke. Arch Phys Med Rehabil 2016; 97:938-46. [PMID: 26850566 DOI: 10.1016/j.apmr.2016.01.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 01/04/2016] [Accepted: 01/08/2016] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To validate the psychometric properties of the Balance Assessment in Sitting and Standing Positions, including validity (unidimensionality and concurrent validity), reliability (Rasch reliability), and responsiveness (compared with the Postural Assessment Scale for Stroke Patients [PASS]) and to transform the Balance Assessment in Sitting and Standing Positions from an ordinal-level measure into an interval-level measure. DESIGN Retrospective cross-sectional study. SETTING Medical records from a medical center. PARTICIPANTS Patients with stroke (N=1193). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The 4-item Balance Assessment in Sitting and Standing Positions was used, assessing static sitting balance, dynamic sitting balance, static standing balance, and dynamic standing balance. RESULTS Data of 1193 patients with stroke were included for Rasch analysis. The 4 items of the Balance Assessment in Sitting and Standing Positions constituted a unidimensional construct (infit/outfit mean square, .75-1.05), had good concurrent validity (r=.70-.90), and had sufficient Rasch reliability (.93). The Balance Assessment in Sitting and Standing Positions had large responsiveness (effect size, 1.20; standardized response mean, 1.51) and was comparable with the PASS (effect size, .90; standardized response mean, 1.32). CONCLUSIONS The Balance Assessment in Sitting and Standing Positions has sound psychometric properties. The transformed-Rasch scores of the Balance Assessment in Sitting and Standing Positions can be used to identify patients' balance function and detect patients' changes.
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Affiliation(s)
- Chien-Yu Huang
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Chen-Yi Song
- Department of Health Promotion and Gerontological Care, Taipei College of Maritime Technology, Taipei, Taiwan
| | - Kuan-Lin Chen
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Physical Medicine and Rehabilitation, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Miau Chen
- Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Wen-Shian Lu
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - I-Ping Hsueh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Lin Hsieh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
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Comparison of the Responsiveness of the Long-Form and Simplified Stroke Rehabilitation Assessment of Movement: Group- and Individual-Level Analysis. Phys Ther 2015; 95:1172-83. [PMID: 25744276 DOI: 10.2522/ptj.20140331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 02/17/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND The group-level responsiveness of the original, 30-item Stroke Rehabilitation Assessment of Movement measure (STREAM-30) is similar to that of the simplified STREAM (STREAM-15), even though the STREAM-30 has twice as many items as those of the STREAM-15. OBJECTIVE The purpose of this study was to compare the responsiveness of the STREAM-30 and STREAM-15 at both group and individual levels in patients with stroke. For the latter level, the Rasch-calibrated 27-item STREAM (STREAM-27) was used because the individual-level indexes of the STREAM-30 could not be estimated. DESIGN A repeated-measurements design was used. In total, 195 patients were assessed with the STREAM-30 at both admission and discharge. METHODS The Rasch scores of the STREAM-27 and STREAM-15 were estimated from the participants' responses on the STREAM-30. We calculated the paired t-test value, effect size, and standardized response mean as the indexes of group-level responsiveness. The significance of change for each participant was estimated as the individual-level responsiveness index, and the paired t test and test of marginal homogeneity were used for individual-level comparisons between the STREAM-27 and STREAM-15. RESULTS At the group level, the STREAM-30, STREAM-27, and STREAM-15 showed sufficient and comparable responsiveness. At the individual level, the STREAM-27 detected significantly more participants with significant improvement and fewer participants with no change or deterioration compared with the STREAM-15. LIMITATIONS Few patients with subacute stroke showed deterioration at discharge, so the abilities of the 2 measures to detect deterioration remain inconclusive. CONCLUSIONS The STREAM-27 detected more participants with significant recovery compared with the STREAM-15, although the group-level responsiveness of the 2 measures was the same. The STREAM-27 is recommended as an outcome measure to demonstrate the treatment effects of movement and mobility for patients with stroke.
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