Validation of a Standardized Assessment of Postural Control in Stroke Patients

Abstract

Background and Purpose —Few clinical tools available for assessment of postural abilities are specifically designed for stroke patients. Most have major floor or ceiling effects, and their metrological properties are not always completely known. Methods —The Postural Assessment Scale for Stroke patients (PASS), adapted from the BL Motor Assessment, was elaborated in concordance with 3 main ideas: (1) the ability to maintain a given posture and to ensure equilibrium in changing position both must be assessed; (2) the scale should be applicable for all patients, even those with very poor postural performance; and (3) it should contain items with increasing difficulty. This new scale has been validated in 70 patients tested on the 30th and 90th days after stroke onset. Results —Normative data obtained in 30 age-matched healthy subjects are presented. The PASS meets the following requirements: (1) good construct validity: high correlation with concomitant Functional Independence Measure (FIM) scores ( r =0.73, P =10 −6 ), with lower-limb motricity scores ( r =0.78, P <10 −6 ), and with an instrumental measure of postural stabilization ( r =0.48, P <10 −2 ); (2) excellent predictive validity: high correlation between PASS scores on the 30th day and FIM scores on the 90th day ( r =0.75, P <10 −6 ); (3) high internal consistency (Cronbach α-coefficient=0.95); and (4) high interrater and test-retest reliabilities (average κ=0.88 and 0.72). Conclusions —Our results confirm that the PASS is one of the most valid and reliable clinical assessments of postural control in stroke patients during the first 3 months after stroke.

Psychometric properties of Brief‐Balance Evaluation Systems Test (Brief‐BESTest) in evaluating balance performance in individuals with chronic stroke

“…The BBS had good intra‐rater reliability (ICC = 0.98), inter‐rater reliability (ICC = 0.97) (Godi et al., 2013; Mao et al., 2002). On the other hand, the PASS consists of 12 items, and the score range for each item was from 0 to 3, yielding a maximum score of 36 (Benaim et al., 1999). The intra‐rater and inter‐rater reliability (0.84 and 0.99 respectively) and concurrent validity (correlation with BBS: 0.92–0.95) were good (Chien, Hu, Tang, Sheu, & Hsieh, 2007; Mao et al., 2002).…”

Estudo comparativo entre a relação do hemisfério acometido no acidente vascular encefálico e a evolução funcional em indivíduos destros

“…Functional performance was assessed with the following scales: the Medical Research Council, which classifies muscular strength into grades that vary from zero to five and is frequently used in clinical practice; the Postural Assessment Stroke Scale 29 , which assesses maintenance and change of postures from lying on one's side to single limb stance; the Functional Ambulation Classification 30 , which classifies the amount of assistance needed for ambulation on a scale from zero to four; and the Barthel Index 31 , which assesses functional independence during performance of activities of daily living. The Star Cancellation Test 32 assesses the ability to perceive visual stimuli and was also used to assess spatial attention.…”

Análise da independência funcional, qualidade de vida, força muscular respiratória e mobilidade torácica em pacientes hemiparéticos submetidos a um programa de reabilitação: estudos de caso

“…Para Benaim et al (1999), após um AVE, ter a capacidade de controlar o equilíbrio na posição sentada e em pé é uma habilidade fundamental do comportamento motor para alcançar independência nas atividades cotidianas. Estudos verificaram que após um AVE há uma diminuição da ativação dos músculos abdominais, com consequente alteração no posicionamento da caixa torácica, que tende a permanecer em uma posição de inspiração.…”

“…Validada por Benaim et al (1999), essa escala contém 12 itens que avaliam a habilidade de manter o equilíbrio durante a manutenção ou mudança de uma dada postura (deitado, sentado ou em pé). A pontuação total é de 36 pontos, e, para cada item, varia de zero a três pontos, onde zero significa incapacidade de realizar a atividade e três a capacidade de realizá-la sem auxílio.…”

“…A pontuação total é de 36 pontos, e, para cada item, varia de zero a três pontos, onde zero significa incapacidade de realizar a atividade e três a capacidade de realizá-la sem auxílio. Quanto mais alta a pontuação total, melhor o controle de tronco do paciente hemiparético (BENAIM et al, 1999).…”