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http://dx.doi.org/10.15268/ksim.2017.5.1.043

The Relative·Absolute Reliability and Validity of Step Test in Patients with Chronic Stroke  

Lee, Byoungkwon (Dept. of Physical Therapy, Konyang University of Medicine and Science)
Choi, Hyunsoo (Dept. of Convergence Information Technology, Konyang University)
An, Seungheon (Dept. of Physical Therapy, National Rehabilitation Center)
Publication Information
Journal of The Korean Society of Integrative Medicine / v.5, no.1, 2017 , pp. 43-53 More about this Journal
Abstract
Purpose : To examine the relative absolute reliability and validity of step test (ST) scores in subjects with chronic stroke. Method : A total of 27 stroke patients, participated in the study. A relative reliability index (intraclass correlation coefficient, ICC) was used to examine the level of agreement of inter-rater test-retest reliability for ST score. Absolute reliability indices, including the standard error of measurement(SEM) and the minimal detectable change (MDC), and limits of agreement by Bland and Altman analysis. The validity was demonstrated by spearman correlation of ST score with 10 m Walk Test (10mWT), Fugl-Meyer Assessment-Lower/Extremity (FMA-L/E)-total score, Berg Balance Scale (BBS)-total score. Result : An excellent inter-rater reliability in ST scores was found (paretic, ICC=0.993~0.996; nonparetic, ICC=0.982~0.991). In addition, excellent test-retest reliability was found (paretic, ICC=0.992; nonparetic, ICC=0.967). It all showed acceptable SEM of the ST score as paretic and nonparetic were 0.22 and 0.46 respectively (average score <10 %), and the MDC of the paretic and nonparetic were 0.61 and 1.27 respectively (possible highest score <20 %). indicating that measures had a small and acceptable measurement error. The ST score of paretic and nonparetic were also found to be significantly associated with 10MWT (r=0.77~0.79), FMA-LE scores (r=0.73~0.81) and BBS scores (r=0.72~0.76). Conclusion : The ST showed highly sufficient Inter-rater test-retest agreement and validity and acceptable measurement errors caused by due to chance variation in measurement. It also can be used by clinicians and researchers to assess the balance and mobility performance and monitor functional change in chronic stroke patients.
Keywords
balance; mobility performance; absolute reliability; step test; stroke;
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1 Curtin F, Schulz P(1998). Multiple correlations and Bonferroni's correction. Biol Psychiatry, 44(8), 775-777.   DOI
2 Weir JP(2005). Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res, 19(1), 231-240.   DOI
3 Wong SS, Yam MS, Ng SS(2013). The figure of eight walk test: reliability and associations with stroke-specific impairments. Disabil Rehabil, 35(22), 1896-1902.   DOI
4 Desrosiers J, Malouin F, Bourbonnais D, et al(2003). Arm and leg impairments and disabilities after stroke rehabilitation: relation to handicap. Clin Rehabil, 17(6), 666-673.   DOI
5 de Menezes KK, Scianni AA, Faria-Fortini I, et al(2015). Measurement properties of the lower extremity motor coordination test in individuals with stroke. J Rehabil Med, 47(6), 502-507.   DOI
6 Duncan PW, Propst M, Nelson SG(1983). Reliability of the Fugl-Meyer assessment of sensorimotor recovery following cerebrovascular accident. Phys Ther, 63(10), 1606-1610.   DOI
7 Flansbjer UB, Blom J, Brogardh C(2012). The reproducibility of berg balance scale and the single-leg stance in chronic stroke and the relationship between the two tests. PM R, 4(3), 165-170.   DOI
8 Flansbjer UB, Holmback AM, Downham D, et al(2005). Reliability of gait performance tests in men and women with hemiparesis after stroke. J Rehabil Med, 37(2), 75-82.   DOI
9 Fugl-Meyer AR, Jaasko L, Leyman I, et al(1975). The post-stroke hemiplegic patient, 1: a method for evaluation of physical performance. Scand J Rehabil Med, 7(1), 13-31.
10 Geurts ACH, de Haart M, van Nes IJW, et al(2005). A review of standing balance recovery from stroke. Gait Posture, 22(3), 267-281.   DOI
11 Goh EY, Chua SY, Hong SJ, et al(2013). Reliability and concurrent validity of four square step test scores in subjects with chronic stroke: A pilot study. Arch Phys Med Rehabil, 94(7), 1306-1311.   DOI
12 Hiengkaew V, Jitaree K, Chaiyawat P(2012). Minimal detectable changes of the Berg Balance Scale, Fugl-Meyer Assessment Scale, Timed "Up & Go" Test, gait speeds, and 2-minute walk test in individuals with chronic stroke with different degrees of ankle plantarflexor tone. Arch Phys Med Rehabil, 93(7), 1201-1208.   DOI
13 Bernhardt J, Ellis P, Denisenko S, et al(1998). Changes in balance and locomotion measures during rehabilitation following stroke. Physiother Res Int, 3(2), 109-122.   DOI
14 Hill KD, Berhardt J, McGann AM, et al(1996). A new test of dynamic standing balance for stroke patients: reliability, validity and comparison with healthy elderly. Physiother Can, 48(4), 257-262.   DOI
15 Altman DG, Bland JM(1983). Measurement in medicine: the analysis of method comparison studies. Statistician, 32(3), 307-317.   DOI
16 Atkinson G, Nevill AM(1998). Statistical methods for assessing measurement error (reliability) in variables relevant to sports medicine. Sports Med, 26(4), 217-238.   DOI
17 Berg KO, Maki BE, Williams JI, et al(1992). Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil, 73(11), 1073-1080.
18 Berg KO, Wood-Dauphinee SL, Williams JI, et al(1992). Measuring balance in the elderly: validation of an instrument. Can J Public Health, 83(suppl 2), S7-S11.
19 Bland JM, Altman DG(1986). Statistical methods for assessing agreement between two methods of clinical measurement. Lancet, 1(8476), 307-310.
20 Hong SJ, Goh EY, Chua SY, et al(2012). Reliability and validity of step test scores in subjects with chronic stroke. Arch Phys Med Rehabil, 93(6), 1065-1071.   DOI
21 Hsieh YW, Hsueh IP, Chou YT, et al(2007). Development and validation of a short form of the Fugl-Meyer motor scale in patients with stroke. Stroke, 38(11), 3052-3054.   DOI
22 Hsu AL, Tang PF, Jan MH(2003). Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil, 84(8), 1185-1193.   DOI
23 Lin PY, Yang YR, Cheng SJ, et al(2006). The relation between ankle impairments and gait velocity and symmetry in people with stroke. Arch Phys Med Rehabil, 87(4), 562-568.   DOI
24 Hsueh IP, Hsu MJ, Sheu CF, et al(2008). Psychometric comparisons of 2 versions of the Fugl-Meyer motor scale and 2 versions of the stroke rehabilitation assessment of movement. Neurorehabil Neural Repair, 22(6), 737-744.   DOI
25 Jorgensen HS, Nakayama H, Raaschou HO, et al(1995). Outcome and time course of recovery in stroke. Part II: time course of recovery. Arch Phys Med Rehabil, 76(5), 406-412.   DOI
26 Levin MF, Hui-Chan CW(1992). Relief of hemiparetic spasticity by TENS is associated with improvement in reflex and voluntary motor functions. Electroencephalogr Clin Neurophysiol, 85(2), 131-142.   DOI
27 Liaw LJ, Hsieh CL, Lo SK, et al(2008). The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disabil Rehabil, 30(9), 656-666.   DOI
28 Lin JH, Hsu MJ, Hsu HW, et al(2010). Psychometric comparisons of 3 functional ambulation measures for patients with stroke. Stroke, 41(9), 2021-2025.   DOI
29 Lu WS, Wang CH, Lin JH, et al(2008). The minimal detectable change of the simplified stroke rehabilitation assessment of movement measure. J Rehabil Med, 40(8), 615-619.   DOI
30 Mackintosh SF, Hill KD, Dodd KJ, et al(2006). Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation. Arch Phys Med Rehabil, 87(12), 1583-1589.   DOI
31 Malouin F, Pichard L, Bonneau C, et al(1994). Evaluating motor recovery early after stroke: comparison of the Fugl-Meyer assessment and the motor assessment scale. Arch Phys Med Rehabil, 75(11), 1206-1212.   DOI
32 Mayo N, Wood-Dauphinee S, Coyte R, et al(2002). Activity, participation, and quality of life 6 months poststroke. Arch Phys Med Rehabil, 83(8), 1035-1042.   DOI
33 Sanford J, Moreland J, Swanson LR, et al(1993). Reliability of the Fugl-Meyer assessment for testing motor performance in patients following stroke. Phys Ther, 73(7), 447-454.   DOI
34 Mercer VS, Freburger JK, Chang SH, et al(2009). Step test scores are related to measures of activity and participation in the first 6 months after stroke. Phys Ther, 89(10), 1061-1071.   DOI
35 Patten C, Kothari D, Whitney J, et al(2003). Reliability and responsiveness of elbow trajectory tracking in chronic poststroke hemiparesis. J Rehabil Res Dev, 40(6), 487-500.   DOI
36 Patterson SL, Forrester LW, Rodgers MM, et al(2007). Determinants of walking function after stroke: differences by deficit severity. Arch Phys Med Rehabil, 88(1), 115-119.   DOI
37 Said CM, Goldie PA, Culham E, et al(2005). Control of lead and trail limbs during obstacle crossing following stroke. Phys Ther, 85(5), 413-427.
38 Salbach NM, Mayo NF, Higgins J, et al(2001). Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil, 82(9), 1204-1212.   DOI
39 Salter K, Jutai JW, Teasell R, et al(2005). Issues for selection of outcome measures in stroke rehabilitation: ICF body functions. Disabil Rehabil, 27(4), 191-207.   DOI
40 Stevenson TJ(2001). Detecting change in patients with stroke using the berg balance scale. Aust J Physiother, 47(1), 29-38.   DOI
41 Tyson SF, DeSouza LH(2004). Reliability and validity of functional balance tests post stroke. Clin Rehabil, 18(8), 916-923.   DOI
42 Tyson SF, Hanley M, Chillala J, et al(2006). Balance disability after stroke. Phys Ther, 86(1), 30-38.   DOI
43 Wang Y, Zatsiorsky VM, Latash ML(2006). Muscle synergies involved in preparation to step made under the self-paced and reaction time instructions. Clin Neurophysiol, 117(1), 41-56.   DOI
44 Chen KL, Chou YT, Yu WH, et al(2015). A prospective study of the responsiveness of the original and the short form Berg Balance Scale in people with stroke. Clin Rehabil, 29(5), 468-476.   DOI
45 Blennerhassett JM, Dite W, Ramage ER, et al(2012). Changes in balance and walking from stroke rehabilitation to the community: a follow-up observational study. Arch Phys Med Rehabil, 93(10), 1782-1787.   DOI
46 Chen HM, Hsieh CL, Sing Kai Lo, et al(2007). The test-retest reliability of 2 mobility performance tests in patients with chronic stroke. Neurorehabil Neural Repair, 21(4), 347-352.   DOI
47 Chen KL, Chen CT, Chou YT, et al(2014). Is the long form of the Fugl-Meyer motor scale more responsive than the short form in patients with stroke? Arch Phys Med Rehabil, 95(5), 941-949.   DOI
48 Chou CY, Chien CW, Hsueh IP, et al(2006). Developing a short form of the Berg Balance Scale for people with stroke. Phys Ther, 86(2), 195-204.