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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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Huang WY, Li MH, Lee CH, Tuan SH, Sun SF, Liou IH. Efficacy of lateral stair walking training in patients with chronic stroke: A pilot randomized controlled study. Gait Posture 2021; 88:10-15. [PMID: 33946024 DOI: 10.1016/j.gaitpost.2021.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/21/2021] [Accepted: 04/14/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Patients with chronic stroke have reduced capacity for performing activities of daily living (ADLs) and are at increased risk for falls during walking due to long-term changes to muscle tone and force, as well as movement control. RESEARCH QUESTION To investigate the efficacy of lateral stair walking training on muscle strength of affected lower extremities, balance, ADLs, and gait ability in patients with chronic stroke. METHODS The experimental group received 15 min of lateral stair walking exercise along with 15 min of traditional physiotherapy, whereas the control group received only traditional physiotherapy for 30 min. Both groups received the intervention once a week for 12 weeks. Outcome measurements included muscle strength, postural assessment scale for stroke patients (PASS), Fugal-Meyer assessment for lower extremity (FMA-LE), Barthel index (BI), timed up and go test (TUG), and the gait parameters which were determined by the Reha-Watch system. RESULTS A total of 24 participants completed the study. The experimental group showed significant improvements in hip extensor, flexor, and abductor strength of the affected limb, FMA-LE, BI, TUG, and gait parameters of stride length, velocity, and cadence. Significant differences in affected limb ankle plantar strength (p = 0.024), PASS (p = 0.017), BI (p = 0.039), TUG (p = 0.049), and gait velocity (p < 0.001) were observed between the 2 groups. SIGNIFICANCE Lateral stair walking training alongside physical therapy resulted in significant improvements in hip muscle strength and gait parameters in patients with chronic stroke. Our results support the incorporation of lateral stair walking training into clinical rehabilitation programs. Lateral stair walking training in patients with chronic stroke can be used as an effective treatment to improve gait, balance performance, and ADLs.
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Affiliation(s)
- Wan-Yun Huang
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| | - Min-Hui Li
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Taiwan.
| | - Chao-Hsien Lee
- Department of Health Business Administration, Meiho University, Pingtung, Taiwan.
| | - Sheng-Hui Tuan
- Department of Rehabilitation Medicine, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.
| | - Shu-Fen Sun
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
| | - I-Hsiu Liou
- Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
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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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Maso I, Pinto EB, Monteiro M, Makhoul M, Mendel T, Jesus PAP, Oliveira-Filho J. A Simple Hospital Mobility Scale for Acute Ischemic Stroke Patients Predicts Long-term Functional Outcome. Neurorehabil Neural Repair 2019; 33:614-622. [PMID: 31226906 DOI: 10.1177/1545968319856894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. Stroke patients present restriction of mobility in the acute phase, and the use of a simple and specific scale can be useful to guide rehabilitation. Objective. To validate and propose a Hospital Mobility Scale (HMS) for ischemic stroke patients as well as to evaluate the HMS as a prognostic indicator. Methods. This study was performed in 2 phases: in the first, we developed the HMS content, and in the second, we defined its score and evaluated its psychometric properties. We performed a longitudinal prospective study consisting of 2 cohorts (derivation and validation cohorts). The data were collected in a stroke unit, and the following scales were applied during hospitalization: National Institutes of Health Stroke Scale to quantify stroke severity and the HMS to verify the degree of mobility. The primary outcome was the proportion of unfavorable functional outcomes, defined as a modified Barthel Index of <95. Results. We defined 3 tasks for HMS: sitting, standing, and gait. In the derivation cohort, the HMS presented an accuracy of 84.5% measured using the area under the receiver operating characteristic curve (95% CI = 78.3-90.7; P < .001), whereas in the validation cohort the accuracy was 87.8% (95% CI = 81.9%-93.7%; P < .001). The HMS presented a large standardized effect size (1.41) and excellent interexaminer agreement (intraclass correlation coefficient = 0.962; 95% CI = 0.917-0.983; P < .001). Conclusion. The HMS was able to predict accurately the functional outcome of poststroke patients, presented excellent interexaminer agreement, and was sensitive in detecting changes.
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Affiliation(s)
- Iara Maso
- 1 Federal University of Bahia, Salvador-BA, Brazil.,2 Bahiana School of Medicine and Public Health, Salvador-BA, Brazil.,3 Roberto Santos General Hospital, Salvador-BA, Brazil
| | - Elen Beatriz Pinto
- 1 Federal University of Bahia, Salvador-BA, Brazil.,2 Bahiana School of Medicine and Public Health, Salvador-BA, Brazil
| | - Maiana Monteiro
- 2 Bahiana School of Medicine and Public Health, Salvador-BA, Brazil
| | - Marina Makhoul
- 2 Bahiana School of Medicine and Public Health, Salvador-BA, Brazil
| | - Tassiana Mendel
- 2 Bahiana School of Medicine and Public Health, Salvador-BA, Brazil
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Yu WH, Chen KL, Huang SL, Lu WS, Lee SC, Hsieh CL. Intrarater and Interrater Reliability of the Hierarchical Balance Short Forms in Patients With Stroke. Arch Phys Med Rehabil 2016; 97:2137-2145.e2. [PMID: 27465751 DOI: 10.1016/j.apmr.2016.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2015] [Revised: 07/04/2016] [Accepted: 07/05/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the intrarater and interrater reliability of a quick balance measure, the Hierarchical Balance Short Forms (HBSF), in outpatients with stroke receiving rehabilitation. DESIGN A repeated-assessments design (1wk apart) was used to examine the intrarater and interrater reliability of the HBSF. The HBSF was administered by a single rater in the intrarater reliability study and by 2 raters in the interrater reliability study. The raters had sufficient working experience in stroke rehabilitation. SETTING Seven teaching hospitals. PARTICIPANTS Two independent groups of outpatients (N=106; each group, n=53) with stroke in chronic stages and in stable medical condition were recruited. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE HBSF. RESULTS For the intrarater reliability study, the values of the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and percentage of minimal detectable change (MDC%) were .95, 1.02, and 16.3%, respectively, for the HBSF. The 95% limits of agreement (LOA) of the HBSF ranged from -.69 to 1.19. For the interrater reliability study, the values of the ICC, MDC, and MDC% were .91, 1.22, and 18.3%, respectively, for the HBSF. The 95% LOA of the HBSF ranged from -1.01 to 1.35. CONCLUSIONS Our results suggest that the HBSF has satisfactory intrarater and interrater reliability for assessing balance function in outpatients with stroke. The MDC values of the HBSF are useful for both researchers and clinicians to determine whether the change in balance function of an individual patient is real when administered by an individual rater or by different raters.
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Affiliation(s)
- Wan-Hui Yu
- School of Occupational Therapy, College of Medicine, National Taiwan University, 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, Tainan, 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
| | - Wen-Shian Lu
- School of Occupational Therapy, Chung Shan Medical University, Taichung, Taiwan; Occupational Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Shu-Chun Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Occupational Therapy, Taipei City Hospital Songde Branch, 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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Hung MC, Lu WS, Chen SS, Hou WH, Hsieh CL, Wang JD. Validation of the EQ-5D in Patients with Traumatic Limb Injury. JOURNAL OF OCCUPATIONAL REHABILITATION 2015; 25:387-393. [PMID: 25261389 DOI: 10.1007/s10926-014-9547-0] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE The measurement properties of the EQ-5D have not been explored for patients with traumatic limb injuries. The purpose of this study was to examine the construct validity, predictive validity, and responsiveness of the EQ-5D in patients with traumatic limb injuries. METHODS A consecutive cohort of 1,167 patients was assessed with the EQ-5D and the World Health Organization Quality of Life instrument (WHOQOL-BREF) at baseline while the patients were hospitalized because of the injury, and the patients were followed up at 3 months (1,003 patients), 6 months (1,010 patients), and 12 months (987 patients) after injury via telephone interview. RESULTS The utility and visual analogue scale (VAS) scores of the EQ-5D had moderate to high association with the physical and psychological domains and the two general questions (overall QOL and overall health) of the WHOQOL-BREF at all time points except baseline (Pearson's correlation coefficient >0.3), but the EQ-5D profiles were weakly associated with the social and environment domains of the WHOQOL-BREF (absolute value of Spearman's correlation coefficient <0.3). These results indicate that the EQ-5D has satisfactory construct validity. The utility and VAS scores of the EQ-5D at 3 and 6 months after injury can predict (with moderate to large relationships) the four domains and two general questions of the WHOQOL-BREF administered at 12 months after injury. The responsiveness of the utility and VAS of the EQ-5D were high (effect sizes >0.9) at 0-3, 0-6, and 0-12 months after injury. CONCLUSIONS The EQ-5D has sufficient construct validity, predictive validity, and responsiveness, and also provides evidence for using the utility of the EQ-5D for cost-utility analyses of patients with traumatic limb injuries in the future.
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Affiliation(s)
- Mei-Chuan Hung
- Department of Public Health, National Cheng Kung University College of Medicine, Tainan, Taiwan
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Lee YC, Chen SS, Koh CL, Hsueh IP, Yao KP, Hsieh CL. Development of two Barthel Index-based Supplementary Scales for patients with stroke. PLoS One 2014; 9:e110494. [PMID: 25329051 PMCID: PMC4203801 DOI: 10.1371/journal.pone.0110494] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 09/16/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The Barthel Index (BI) assesses actual performance of activities of daily living (ADL). However, comprehensive assessment of ADL functions should include two other constructs: self-perceived difficulty and ability. OBJECTIVE The aims of this study were to develop two BI-based Supplementary Scales (BI-SS), namely, the Self-perceived Difficulty Scale and the Ability Scale, and to examine the construct validity of the BI-SS in patients with stroke. METHOD The BI-SS was first developed by consultation with experts and then tested on patients to confirm the clarity and feasibility of administration. A total of 306 participants participated in the construct validity study. Construct validity was investigated using Mokken scale analysis and analyzing associations between scales. The agreement between each pair of the scales' scores was further examined. RESULTS The Self-perceived Difficulty Scale consisted of 10 items, and the Ability Scale included 8 items (excluding both bladder and bowel control items). Items in each individual scale were unidimensional (H ≥ 0.5). The scores of the Self-perceived Difficulty and Ability Scales were highly correlated with those of the BI (rho = 0.78 and 0.90, respectively). The scores of the two BI-SS scales and BI were significantly different from each other (p<.001). These results indicate that both BI-SS scales assessed unique constructs. CONCLUSIONS The BI-SS had overall good construct validity in patients with stroke. The BI-SS can be used as supplementary scales for the BI to comprehensively assess patients' ADL functions in order to identify patients' difficulties in performing ADL tasks, plan intervention strategies, and assess outcomes.
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Affiliation(s)
- Ya-Chen Lee
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Sheng-Shiung Chen
- Department of Physical Medicine and Rehabilitation, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Chia-Lin Koh
- School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, 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, Zhongzheng District, Taipei, Taiwan
- * E-mail:
| | - Kai-Ping Yao
- Department of Psychology, College of Science, 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, Zhongzheng District, Taipei, Taiwan
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Chern JS, Chen MH, Lee YC, Chen SS, Lin LF, Hou WH, Hsieh CL. Validation of a Chinese version of the Frenchay Activities Index in patients with traumatic limb injury. JOURNAL OF OCCUPATIONAL REHABILITATION 2014; 24:439-445. [PMID: 24077894 DOI: 10.1007/s10926-013-9477-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE The Frenchay Activities Index (FAI) is a frequently used measure that assesses instrumental activities of daily living (IADL). However, the measurement properties of the FAI are largely unknown for patients with traumatic limb injuries. The purpose of this study was to examine the measurement properties of a Chinese version of the FAI, including score distribution, internal consistency, construct validity, predictive validity, and responsiveness in patients with traumatic limb injuries. METHODS We performed a secondary data analysis, primarily using non-parametric item response theory, on a data set. The FAI and the World Health Organization Quality of Life Assessment (WHOQOL-BREF) were administered via telephone interview to a cohort of patients at 3, 6, and 12 months after injury. Totals of 342 patients' data (at 3 months after injury), 1,010 patients' data (6 months), and 987 patients' data (12 months) were available for analysis. RESULTS After the deletion of 5 items (i.e., travel outings, gardening, household/car maintenance, reading books, and gainful work), the 10-item revised FAI (R-FAI) formed a unidimensional construct. The R-FAI exhibited a unidimensional construct at each of the 3 time points. The R-FAI had sufficient score distribution, internal consistency, predictive validity, and responsiveness in patients with limb injuries. CONCLUSIONS Our results support the conclusion that the R-FAI has satisfactory measurement properties. The R-FAI is useful for assessing IADL in patients with limb injuries.
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