Validation of a Standardized Assessment of Postural Control in Stroke Patients

Stroke - Tập 30 Số 9 - Trang 1862-1868 - 1999
Charles Bénaim1, D. Pérennou1, Jacqueline Villy1, M Rousseaux1, J. Pélissier1
1From the Département de Médecine Physique et Réadaptation (C.B., D.A.P., J.V., J.Y.P.), CHU Nı̂mes, Centre Médical, Nı̂mes, France; and Service de Rééducation et Convalescence Neurologique (M.R.), CHU Lille, Hôpital Swynghedauw, Lille, France.

Tóm tắt

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.

Từ khóa


Tài liệu tham khảo

10.1159/000213814

10.1161/str.17.4.3526649

10.1136/jnnp.48.1.7

Ashburn A. A physical assessment for stroke patients. Physiotherapy. 1982;68:109–113.

10.1093/ptj/65.2.175

10.1136/jnnp.53.7.576

Feigenson J, Polkow L, Meikle R, Ferguson W. Burke stroke time-oriented profile (BUSTOP): an overview of patient function. Arch Phys Med Rehabil. 1979;60:508–511.

10.2340/1650197771331

10.1161/str.24.1.8418551

Lindmark B, Hamrin E. Evaluation of functional capacity after stroke as a basis for intervention: presentation of a modified chart for motor capacity assessment and its reliability. Scand J Rehabil Med. 1988;20:103–109.

10.1016/S0031-9406(10)63474-8

10.1177/026921559300700102

Brun V, Dhoms G, Henrion G, Codine P, Founeau H, Terraza M. L’équilibre postural de l’hémiplégique par accident vasculaire cérébral: méthodologie d’évaluation et étude corrélative. Ann Readapt Med Phys. 1993;36:169–177.

10.3138/ptc.48.4.257

10.1161/str.21.1.2300995

10.1093/ptj/66.10.1548

Keiser K, Kuypers H. Distribution of corticospinal neurons with collaterals to the lower brain stem reticular formation in monkey (Macaca Fascicularis). Exp Brain Res. 1989;74:311–318.

10.1113/jphysiol.1994.sp020063

10.1161/str.21.5.2339453

10.1093/ptj/73.7.447

Held JP, Pierrot-Desselligny E, Bussel B, Perrigot M, Mahler M. Devenir des hémiplégies vasculaires par atteinte sylvienne en fonction du côté de la lésion. Ann Readapt Med Phys. 1975;18:592–604.

10.1016/S0304-3940(98)00501-1

Semmes J Weinstein S Ghent L Teuber H. Somatosensory Changes After Penetrating Brain Wounds in Man. Cambridge Mass: Harvard University Press; 1960.

Ashworth B. Preliminary trial of carisoprodol in multiple sclerosis. Practitioner. 1992;1964:540–542.

10.1080/09602019108401377

Hamilton BB Granger CV Sherwin FS Zielezny M Tashman JS. A uniform national data system for medical rehabilitation. In: Fuhrer MJ ed. Rehabilitation Outcomes: Analysis and Measurement. Baltimore Md: Brooks; 1987.

Pérennou DA, Amblard B, Laassel EM, Pélissier J. Hemispheric asymmetry in the visual contribution to postural control in healthy adults. Neuroreport. 1997;8:313–314.

10.1016/0959-4388(94)90137-6

McDowell I Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires. New York NY: Oxford University Press; 1987.

10.3138/ptc.41.6.304

10.1016/0003-9993(94)90006-X

Poole JL, Whitney SL. Motor assessment scale for stroke patients concurrent validity and interrater reliability. Arch Phys Med Rehabil. 1988;69:195–197.

10.1161/str.30.3.580

10.2466/pms.1991.73.1.146

10.1016/S0003-9993(95)81035-8

Dettman MA, Linder MT, Sepic SB. Relationships among walking performance, postural stability, and functional assessments of the hemiplegic patient. Am J Phys Med. 1987;66:77–90.

10.1007/BF00608241

Pérennou DA, Bénaïm C, Rouget E, Rousseaux M, Blard JM, Pélissier J. Posture et équilibre après accident vasculaire cérébral: désavantage de l’hémisphère droit. Rev Neurol. 1999;155:281–290.