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A simplified stroke rehabilitation assessment of movement instrument

Hseuh, I-Ping, Wang, Wen-Chung, Wang, Chun-Hou, Shen, Ching-Fan, Lo, Sing Kai, Lin, Jau-Hong and Hsieh, Ching-Lin 2006, A simplified stroke rehabilitation assessment of movement instrument, Physical therapy, vol. 86, no. 7, pp. 936-943.

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Title A simplified stroke rehabilitation assessment of movement instrument
Author(s) Hseuh, I-Ping
Wang, Wen-Chung
Wang, Chun-Hou
Shen, Ching-Fan
Lo, Sing Kai
Lin, Jau-Hong
Hsieh, Ching-Lin
Journal name Physical therapy
Volume number 86
Issue number 7
Start page 936
End page 943
Publisher American Physical Therapy Association
Place of publication Washington, DC
Publication date 2006-07
ISSN 0031-9023
1538-6724
Keyword(s) motor function
psychometrics
rasch model
stroke
Summary Background and Purpose. An efficient, reliable, and valid instrument for assessing motor function in patients with stroke is needed by both clinicians and researchers. To improve administration efficiency, we applied the multidimensional Rasch model to the 30-item, 3-subscale Stroke Rehabilitation Assessment of Movement (STREAM) instrument to produce a concise, reliable, and valid instrument (simplified STREAM [S-STREAM]) for measuring motor function in patients with stroke. Subjects and Methods. The STREAM (consisting of 3 subscales: upper-limb movements, lower-limb movements, and mobility) was administered to 351 subjects with first stroke occurrence and a median time after stroke of 19.5 months. The unidimensionality of each subscale of the STREAM first was verified with unidimensional Rasch analysis. Each subscale of the STREAM then was simplified by deleting redundant items on the basis of expert opinion and the results of the Rasch analysis. The Rasch reliability of the S-STREAM and the concurrent validity of the S-STREAM with the STREAM were examined with multidimensional Rasch analysis and the intraclass correlation coefficient (ICC), respectively. Results. After deleting the items that did not fit the Rasch model, we found that the 8-item upper-limb movement subscale, the 9-item lower-limb movement subscale, and the 10-item mobility subscale assessed single, unidimensional upper-limb movements, lower-limb movements, and mobility, respectively. We selected 5 items from each subscale to construct the S-STREAM and found that the reliability of each subscale of the resulting simplified instrument was high (Rasch reliability coefficients of [greater than or equal to] .91). The agreement between the subscale scores (Rasch estimates) of the S-STREAM and those of the STREAM was excellent (ICC of [greater than or equal to] .99, with a lower limit for the 95% confidence interval of [greater than or equal to] .985), indicating good concurrent validity of the S-STREAM with the STREAM. Discussion and Conclusion. The S-STREAM demonstrates high Rasch reliability, unidimensionality, and concurrent validity with the STREAM in patients with stroke. Furthermore, the S-STREAM is efficient to administer, as it consists of only half the number of items in the original STREAM. Additional studies to examine other psychometric properties (eg, predictive validity and responsiveness) of the S-STREAM or its psychometric properties in various recovery stages after stroke are needed to further establish its utility in both clinical and research settings.
Language eng
Field of Research 110399 Clinical Sciences not elsewhere classified
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2006, American Physical Therapy Association
Persistent URL http://hdl.handle.net/10536/DRO/DU:30009023

Document type: Journal Article
Collections: School of Health and Social Development
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Every reasonable effort has been made to ensure that permission has been obtained for items included in DRO. If you believe that your rights have been infringed by this repository, please contact drosupport@deakin.edu.au.