Responsiveness of a modified version of the postural assessment scale for stroke patients and longitudinal change in postural control after stroke- Postural Stroke Study in Gothenburg (POSTGOT) -

Abstract

BackgroundResponsiveness data certify that a change in a measurement output represents a real change, not a measurement error or biological variability. The objective was to evaluate the responsiveness of the modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in patients with a first event of stroke. An additional aim was to estimate the change in postural control during the first 12 months after stroke onset.MethodsThe SwePASS assessments were conducted during the first week and 3, 6 and 12 months after stroke in 90 patients. Svensson’s method, Relative Position (RP), Relative Concentration (RC) and Relative Rank Variance (RV), were used to estimate the scale’s responsiveness and the patients’ change in postural control over time.ResultsFrom the first week to 3 months after stroke, the patients improved in terms of postural control with 2 to 12 times larger systematic changes in Relative Position (RP), for which 9 items and the total score showed a significant responsiveness to change when compared to the intrarater reliability measurement error of the SwePASS reported in a previous study. When SwePASS was used to assess change in postural control between the first week and 3 months, 74% of the patients received higher scores while 10% received lower scores, RP 0.31 (95% CI 0.219-0.402). The corresponding figures between 3 and 6 and between 6 and 12 months were 37% and 16%, RP 0.09 (95% CI 0.030-0.152), and 18% and 26%, RP −0.07 (95% CI −0.134- (−0.010)), respectively.ConclusionsThe SwePASS is responsive to change. Postural control evaluated using the SwePASS showed an improvement during the first 6 months after stroke. The measurement property, in the form of responsiveness, shows that the SwePASS scoring method can be considered for use in rehabilitation when assessing postural control in patients after stroke, especially during the first 3 months.

The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability

“…With a median of 19 days between onset and testing and the fact that postural control is likely to improve during the rehabilitation process, it is also possible that SwePASS-NV may have a ceiling effect later on. This is in line with studies on both PASS and SwePASS showing that the tests are especially suited to measure change during the first three months (9,11,34).…”

Rasch analysis of the modified version of the Postural Assessment Scale for Stroke patients: Postural Stroke Study in Gothenburg (POSTGOT)

“…The SwePASS is specifically developed for persons with stroke, modified according to clinical relevance and has also been shown that be quick to perform in clinic [ 1 ]. SwePASS has been investigated in different ways with methods that are recommended to handle ordinal data, concerning its psychometric properties regarding previously presented results of reliability [ 1 ] and responsiveness [ 6 ] as well as the current internal construct validity. The psychometric evidence of the predictive validity [ 2 ] may be interpreted very cautiously.…”

“…There are two types of local independency of items [ 6 , 20 ]. First, there is response dependence, i.e.…”

“…The SwePASS has been shown to be a highly reliable [ 1 ] and valid [ 2 ] scale in acute stroke as well as to be responsive to change over time [ 6 ]. This suggests that the SwePASS may be a reliable and a usable clinical indicator of postural control in activities of lying, sitting and standing .…”

Responsividade da escala de avaliação funcional do sentar e levantar da cadeira para pacientes com distrofia muscular de Duchenne (FES-DMD-D1), no período de um ano

“…A fim de fazer uma interpretação significativa dos resultados das escalas utilizadas é fundamental que os testes sejam confiáveis e capazes de detectar alterações, ou seja, apresentar responsividade (Revicki et al, 2008). Na prática clínica, mesmo uma pequena mudança, melhora ou deterioração, pode fazer diferença nas tomadas de decisão clínica (Persson et al, 2013).…”