Francine Malouin1, Bradford McFadyen, Lise Dion, Carol L Richards. 1. Department of Rehabilitation, Faculty of Medicine, Laval University and Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Canada. Francine.Malouin@rea.ulaval.ca
Abstract
OBJECTIVE: (1) To develop an ordinal scale (content validity) for assessing fluidity of the rise-to-walk task (RTW); (2) to examine the concurrent validity of the fluidity scale; (3) to study the inter-rater reliability of the scale. DESIGN: A group of physical therapists participated in the scale development (content validity); a cross-sectional design was used to study the agreement between the fluidity scale and the fluidity index (criterion measure) obtained with the instrumented method (concurrent validity) and to examine the inter-rater reliability of the scale. SETTING: Rehabilitation centre. SUBJECTS: Nineteen persons with a chronic stroke and 19 age- and gender-matched healthy subjects. MAIN OUTCOME MEASURES: For the validation study: the fluidity index (FI) and the scores from the fluidity scale; for the inter-rater reliability study: duration of the RTW task and fluidity scores. RESULTS: The FI values did not overlap across categories of the scale and the relationship between FI values and the fluidity scores was 0.99. The weighted kappa (kappa(w)) indicated a substantial level of agreement between the new raters (kappa(w) = 0.78) and between the new raters and the expert rater (kappa(w) = 0.71). Corresponding mean intraclass correlation coefficients for the RTW duration were 0.95. CONCLUSION: These results indicate that the descriptors of the scale provided a gradation of fluidity comparable to the gold standard measure (FI) and that trained clinicians can use the fluidity scale with a substantial level of reliability. The RTW task is a simple clinical tool for assessing mobility and motor strategies (locomotor co-ordination) in patients presenting varying degrees of motor recovery after stroke.
OBJECTIVE: (1) To develop an ordinal scale (content validity) for assessing fluidity of the rise-to-walk task (RTW); (2) to examine the concurrent validity of the fluidity scale; (3) to study the inter-rater reliability of the scale. DESIGN: A group of physical therapists participated in the scale development (content validity); a cross-sectional design was used to study the agreement between the fluidity scale and the fluidity index (criterion measure) obtained with the instrumented method (concurrent validity) and to examine the inter-rater reliability of the scale. SETTING: Rehabilitation centre. SUBJECTS: Nineteen persons with a chronic stroke and 19 age- and gender-matched healthy subjects. MAIN OUTCOME MEASURES: For the validation study: the fluidity index (FI) and the scores from the fluidity scale; for the inter-rater reliability study: duration of the RTW task and fluidity scores. RESULTS: The FI values did not overlap across categories of the scale and the relationship between FI values and the fluidity scores was 0.99. The weighted kappa (kappa(w)) indicated a substantial level of agreement between the new raters (kappa(w) = 0.78) and between the new raters and the expert rater (kappa(w) = 0.71). Corresponding mean intraclass correlation coefficients for the RTW duration were 0.95. CONCLUSION: These results indicate that the descriptors of the scale provided a gradation of fluidity comparable to the gold standard measure (FI) and that trained clinicians can use the fluidity scale with a substantial level of reliability. The RTW task is a simple clinical tool for assessing mobility and motor strategies (locomotor co-ordination) in patients presenting varying degrees of motor recovery after stroke.