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Predictive validity of the gait scale in the Performance Oriented Mobility Assessment for stroke survivors: a retrospective cohort study

  • An, Seungheon (Department of Physical Therapy, National Rehabilitation Center) ;
  • Jee, Youngju (Department of Nurse, Kyungnam University) ;
  • Lee, Donggeon (Department of Physical Therapy, Graduate school of Kyungnam University) ;
  • Song, Sunhae (Department of Physical Therapy, Graduate school of Kyungnam University) ;
  • Lee, Gyuchang (Department of Physical Therapy, College of Natural Sciences, Kyungnam University)
  • Received : 2016.01.07
  • Accepted : 2016.03.07
  • Published : 2016.03.30

Abstract

Objective: The present study was to investigate the discrimination capacity of the Performance Oriented Mobility Assessment-Gait Scale (POMA-GS), for predicting falls in stroke survivors. Design: Retrospective cohort study. Methods: Data including the characteristics and number of falls of 52 chronic stroke patients from a rehabilitation center were collected. The number of falls each subject had experienced in the previous year were investigated through interviews. The subjects were divided into two groups depending on the number of falls: if falls occurred twice or more on the basis of the time of study after stroke, they were defined as the falls group and if there was no fall experience or one fall, they were defined as the non-falls group. The subjects were examined with the POMA-GS, and physical functions were examined using by the One Leg Stand Test (OLST), Sit to Stand Test (SST), 10-m Walk Test, Lower Extremity in Fugl-Meyer assessment (FM-LE), and Trunk Impairment Scale (TIS). The validity of POMA-GS for falls prediction was analyzed. Results: In the POMA-GS, which predicts falls in stroke survivors, the cut-off value was 8.5 (sensitivity 72%; specificity 65%) and the area under the curve was 0.75 (95% confidence interval: 0.60-0.90, p<0.007). There was a significant difference in the OLST, SST, FM-LE, and TIS between the subjects with POMA-GS >8.5 and the subjects with POMA-GS ${\leq}8.5$. Conclusions: The POMA-GS could be a useful tool in predicting falls in stroke survivors, as its discrimination capacity and predictive validity is proven satisfactory.

Keywords

References

  1. Capaday C. The special nature of human walking and its neural control. Trends Neurosci 2002;25:370-6. https://doi.org/10.1016/S0166-2236(02)02173-2
  2. Urban PP, Wolf T, Uebele M, Marx JJ, Vogt T, Stoeter P, et al. Occurence and clinical predictors of spasticity after ischemic stroke. Stroke 2010;41:2016-20. https://doi.org/10.1161/STROKEAHA.110.581991
  3. Patterson KK, Parafianowicz I, Danells CJ, Closson V, Verrier MC, Staines WR, et al. Gait asymmetry in community-ambulating stroke survivors. Arch Phys Med Rehabil 2008;89:304-10. https://doi.org/10.1016/j.apmr.2007.08.142
  4. Patterson SL, Forrester LW, Rodgers MM, Ryan AS, Ivey FM, Sorkin JD, et al. Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil 2007;88: 115-9. https://doi.org/10.1016/j.apmr.2006.10.025
  5. Tyson SF, Hanley M, Chillala J, Selley A, Tallis RC. Balance disability after stroke. Phys Ther 2006;86:30-8. https://doi.org/10.1093/ptj/86.1.30
  6. Harada N, Chiu V, Damron-Rodriguez J, Fowler E, Siu A, Reuben DB. Screening for balance and mobility impairment in elderly individuals living in residential care facilities. Phys Ther 1995;75:462-9. https://doi.org/10.1093/ptj/75.6.462
  7. de Oliveira CB, de Medeiros IR, Frota NA, Greters ME, Conforto AB. Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev 2008;45:1215-26. https://doi.org/10.1682/JRRD.2007.09.0150
  8. Shumway-Cook A, Gruber W, Baldwin M, Liao S. The effect of multidimensional exercises on balance, mobility, and fall risk in community-dwelling older adults. Phys Ther 1997;77:46-57. https://doi.org/10.1093/ptj/77.1.46
  9. Wrisley DM, Walker ML, Echternach JL, Strasnick B. Reliability of the dynamic gait index in people with vestibular disorders. Arch Phys Med Rehabil 2003;84:1528-33. https://doi.org/10.1016/S0003-9993(03)00274-0
  10. Tinetti ME. Performance-oriented assessment of mobility problems in elderly patients. J Am Geriatr Soc 1986;34:119-26. https://doi.org/10.1111/j.1532-5415.1986.tb05480.x
  11. Jacobs JV, Horak FB, Tran VK, Nutt JG. Multiple balance tests improve the assessment of postural stability in subjects with Parkinson's disease. J Neurol Neurosurg Psychiatry 2006;77: 322-6.
  12. Maki BE, McIlroy WE. Control of rapid limb movements for balance recovery: age-related changes and implications for fall prevention. Age Ageing 2006;35 Suppl 2:ii12-8. https://doi.org/10.1093/ageing/afj102
  13. Sackley C. The relationship between weight-bearing asymmetry after stroke, motor function and activities of daily living. Physiother Theory Pract 1990;6:179-85. https://doi.org/10.3109/09593989009048293
  14. Bloem BR, Grimbergen YA, Cramer M, Willemsen M, Zwinderman AH. Prospective assessment of falls in Parkinson's disease. J Neurol 2001;248:950-8. https://doi.org/10.1007/s004150170047
  15. Canbek J, Fulk G, Nof L, Echternach J. Test-retest reliability and construct validity of the tinetti performance-oriented mobility assessment in people with stroke. J Neurol Phys Ther 2013;37: 14-9. https://doi.org/10.1097/NPT.0b013e318283ffcc
  16. Daly JJ, Roenigk K, Holcomb J, Rogers JM, Butler K, Gansen J, et al. A randomized controlled trial of functional neuromuscular stimulation in chronic stroke subjects. Stroke 2006;37:172-8. https://doi.org/10.1161/01.STR.0000195129.95220.77
  17. Corriveau H, Hebert R, Raiche M, Prince F. Evaluation of postural stability in the elderly with stroke. Arch Phys Med Rehabil 2004;85:1095-101. https://doi.org/10.1016/j.apmr.2003.09.023
  18. Soyuer F, Ozturk A. The effect of spasticity, sense and walking aids in falls of people after chronic stroke. Disabil Rehabil 2007;29:679-87. https://doi.org/10.1080/09638280600925860
  19. Thomas JI, Lane JV. A pilot study to explore the predictive validity of 4 measures of falls risk in frail elderly patients. Arch Phys Med Rehabil 2005;86:1636-40. https://doi.org/10.1016/j.apmr.2005.03.004
  20. Lamb SE, Jorstad-Stein EC, Hauer K, Becker C; Prevention of Falls Network Europe and Outcomes Consensus Group. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc 2005;53:1618-22. https://doi.org/10.1111/j.1532-5415.2005.53455.x
  21. Sterke CS, Huisman SL, van Beeck EF, Looman CW, van der Cammen TJ. Is the Tinetti Performance Oriented Mobility Assessment (POMA) a feasible and valid predictor of short-term fall risk in nursing home residents with dementia? Int Psychogeriatr 2010;22:254-63. https://doi.org/10.1017/S1041610209991347
  22. Franchignoni F, Tesio L, Martino MT, Ricupero C. Reliability of four simple, quantitative tests of balance and mobility in healthy elderly females. Aging (Milano) 1998;10:26-31.
  23. Mong Y, Teo TW, Ng SS. 5-repetition sit-to-stand test in subjects with chronic stroke: reliability and validity. Arch Phys Med Rehabil 2010;91:407-13. https://doi.org/10.1016/j.apmr.2009.10.030
  24. Ng SS, Ng PC, Lee CY, Ng ES, Tong MH. Walkway lengths for measuring walking speed in stroke rehabilitation. J Rehabil Med 2012;44:43-6. https://doi.org/10.2340/16501977-0906
  25. Flansbjer UB, Holmback AM, Downham D, Patten C, Lexell J. Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med 2005;37:75-82. https://doi.org/10.1080/16501970410017215
  26. Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scand J Rehabil Med 1975;7:13-31.
  27. Duncan PW, Propst M, Nelson SG. Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther 1983;63:1606-10. https://doi.org/10.1093/ptj/63.10.1606
  28. Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil 2004; 18:326-34. https://doi.org/10.1191/0269215504cr733oa
  29. Greiner M, Pfeiffer D, Smith RD. Principles and practical application of the receiver-operating characteristic analysis for diagnostic tests. Prev Vet Med 2000;45:23-41. https://doi.org/10.1016/S0167-5877(00)00115-X
  30. Nakagawa S. A farewell to Bonferroni: the problems of low statistical power and publication bias. Behavi Ecol 2004;15:1044-5. https://doi.org/10.1093/beheco/arh107
  31. Cho KH, Lee WH. Changes of spatio-temporal gait parameters according to experience falls in post-stroke patients. Phys Ther Rehabil Sci 2012;1:22-7.
  32. Park KS, Choi JD. The effect of balance training with plantar flexor stretching on range of motion, balance, and gait in stroke patients: a randomized controlled pilot trial. Phys Ther Rehabil Sci 2015;4:66-72. https://doi.org/10.14474/ptrs.2015.4.2.66
  33. Cho J, Lee E, Lee S. Effects of body weight-supported treadmill training combined with ball-kicking on balance and gait of subacute stroke patients. Phys Ther Rehabil Sci 2015;4:73-8. https://doi.org/10.14474/ptrs.2015.4.2.73
  34. Shin J, Chung Y. The effect of treadmill gait training with patellar taping on gait abilities in chronic stroke patients. Phys Ther Rehabil Sci 2015;4:94-102. https://doi.org/10.14474/ptrs.2015.4.2.94
  35. Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, et al. Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil 2004;85:274-8. https://doi.org/10.1016/j.apmr.2003.06.016
  36. Taylor D, Stretton CM, Mudge S, Garrett N. Does clinic-measured gait speed differ from gait speed measured in the community in people with stroke? Clin Rehabil 20061;20:438-44. https://doi.org/10.1191/0269215506cr945oa
  37. Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, et al. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc 2000;32:S498-504. https://doi.org/10.1097/00005768-200009001-00009
  38. Beninato M, Portney LG, Sullivan PE. Using the International Classification of Functioning, Disability and Health as a framework to examine the association between falls and clinical assessment tools in people with stroke. Phys Ther 2009;89:816-25. https://doi.org/10.2522/ptj.20080160
  39. Yates JS, Lai SM, Duncan PW, Studenski S. Falls in community-dwelling stroke survivors: an accumulated impairments model. J Rehabil Res Dev 2002;39:385-94.
  40. Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke. Arch Phys Med Rehabil 2006;87:554-61. https://doi.org/10.1016/j.apmr.2005.12.027
  41. Sackley CM. Falls, sway, and symmetry of weight-bearing after stroke. Int Disabil Stud 1991;13:1-4. https://doi.org/10.3109/03790799109166267
  42. Andersson AG, Kamwendo K, Seiger A, Appelros P. How to identify potential fallers in a stroke unit: validity indexes of 4 test methods. J Rehabil Med 2006;38:186-91. https://doi.org/10.1080/16501970500478023
  43. Verheyden G, Nieuwboer A, Feys H, Thijs V, Vaes K, De Weerdt W. Discriminant ability of the trunk impairment scale: a comparison between stroke patients and healthy individuals. Disabil Rehabil 2005;27:1023-8. https://doi.org/10.1080/09638280500052872
  44. Verma R, Arya KN, Sharma P, Garg RK. Understanding gait control in post-stroke: implications for management. J Bodyw Mov Ther 2012;16:14-21. https://doi.org/10.1016/j.jbmt.2010.12.005
  45. Cheng PT, Chen CL, Wang CM, Hong WH. Leg muscle activation patterns of sit-to-stand movement in stroke patients. Am J Phys Med Rehabil 2004;83:10-6. https://doi.org/10.1097/01.PHM.0000104665.34557.56

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