Reliability and validity of the sideways step test and its correlation with motor function after stroke

Best Quantitative Tools for Assessing Static and Dynamic Standing Balance after Stroke: A Systematic Review

Purpose: Our objective was to examine the psychometric qualities (reliability and validity) and clinical utility of quantitative tools in measuring the static and dynamic standing balance of individuals after stroke. Method: We searched four databases (PubMed/MEDLINE, PEDro, Embase, and CINAHL) for studies published from January 2018 through September 2019 and included those that assessed the psychometric properties of standing balance tests with an adult stroke population. We evaluated the quality of the studies using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist and assessed each test on a utility assessment scale. Results: A total of 22 studies met the inclusion criteria, and 18 quantitative tools for assessing static or dynamic standing balance of individuals with stroke were analyzed. Findings support good or excellent reliability for all tests, whereas correlations for validity ranged from weak to strong. Study quality was variable. Dynamic balance tests had better clinical utility scores than static ones. Five tests had complete psychometric analyses: quiet standing on a force platform, five-step test, sideways step, step length, and turn tests.

The reliability, validity and correlation of two observational gait scales assessed by video tape for Chinese subjects with hemiplegia

To test the reliability of the Wisconsin Gait Scale (WGS) and the Gait Abnormality Rating Scale (GARS) for hemiplegic Chinese subjects, as well as to establish the concurrent validity of these two scales with clinical measurements. [Subjects] Twenty hemiplegic stroke subjects were recruited for this study. [Methods] The subjects walked along a 10-meter walkway and their gait was videotaped from 4 directions. Two physical therapists assessed the subjects’ gait using the aforementioned scales by watching the video tape. The Intraclass Correlation Coefficient (ICC) was calculated for the two physiotherapists’ scores for each category and the total scores to assess the reliability. Concurrent validity was tested by comparing the total scores to subjects’ walking speed, the Fugl-Meyer assessment, the Motricity Index of the lower limb, and the Composite Spasticity Index of the lower limb. [Results] The ICC of WGS was 0.961 for intra-rater reliability, and 0.945 for inter-rater reliability. The ICC of GARS was 0.708 for intra-rater reliability and 0.875 for inter-rater reliability. The correlations of the two scales with walking speed, the Fugl-Meyer assessment and the Motricity Index were statistically significant. [Conclusion] Both the Wisconsin Gait Scale and the Gait Abnormality Rating Scale are reliable and valid protocols for measuring the hemiplegic gait of stroke patients.