TY - JOUR
T1 - Comparison of the responsiveness of the long-form and simplified stroke rehabilitation assessment of movement
T2 - Group- and individual-level analysis
AU - Huang, Yi Jing
AU - Chen, Kuan Lin
AU - Chou, Yeh Tai
AU - Hsueh, I. Ping
AU - Hou, Chieh Yi
AU - Hsieh, Ching Lin
N1 - Publisher Copyright:
© 2015 American Physical Therapy Association.
PY - 2015/8/1
Y1 - 2015/8/1
N2 - Background. The group-level responsiveness of the original, 30-item Stroke Rehabilitation Assessment of Movement measure (STREAM-30) is similar to that of the simplified STREAM (STREAM-15), even though the STREAM-30 has twice as many items as those of the STREAM-15. Objective. The purpose of this study was to compare the responsiveness of the STREAM-30 and STREAM-15 at both group and individual levels in patients with stroke. For the latter level, the Rasch-calibrated 27-item STREAM (STREAM-27) was used because the individual-level indexes of the STREAM-30 could not be estimated. Design. A repeated-measurements design was used. In total, 195 patients were assessed with the STREAM-30 at both admission and discharge. Methods. The Rasch scores of the STREAM-27 and STREAM-15 were estimated from the participants’ responses on the STREAM-30. We calculated the paired t-test value, effect size, and standardized response mean as the indexes of group-level responsiveness. The significance of change for each participant was estimated as the individual-level responsiveness index, and the paired t test and test of marginal homogeneity were used for individual-level comparisons between the STREAM-27 and STREAM-15. Results. At the group level, the STREAM-30, STREAM-27, and STREAM-15 showed sufficient and comparable responsiveness. At the individual level, the STREAM-27 detected significantly more participants with significant improvement and fewer participants with no change or deterioration compared with the STREAM-15. Limitations. Few patients with subacute stroke showed deterioration at discharge, so the abilities of the 2 measures to detect deterioration remain inconclusive. Conclusions. The STREAM-27 detected more participants with significant recovery compared with the STREAM-15, although the group-level responsiveness of the 2 measures was the same. The STREAM-27 is recommended as an outcome measure to demonstrate the treatment effects of movement and mobility for patients with stroke.
AB - Background. The group-level responsiveness of the original, 30-item Stroke Rehabilitation Assessment of Movement measure (STREAM-30) is similar to that of the simplified STREAM (STREAM-15), even though the STREAM-30 has twice as many items as those of the STREAM-15. Objective. The purpose of this study was to compare the responsiveness of the STREAM-30 and STREAM-15 at both group and individual levels in patients with stroke. For the latter level, the Rasch-calibrated 27-item STREAM (STREAM-27) was used because the individual-level indexes of the STREAM-30 could not be estimated. Design. A repeated-measurements design was used. In total, 195 patients were assessed with the STREAM-30 at both admission and discharge. Methods. The Rasch scores of the STREAM-27 and STREAM-15 were estimated from the participants’ responses on the STREAM-30. We calculated the paired t-test value, effect size, and standardized response mean as the indexes of group-level responsiveness. The significance of change for each participant was estimated as the individual-level responsiveness index, and the paired t test and test of marginal homogeneity were used for individual-level comparisons between the STREAM-27 and STREAM-15. Results. At the group level, the STREAM-30, STREAM-27, and STREAM-15 showed sufficient and comparable responsiveness. At the individual level, the STREAM-27 detected significantly more participants with significant improvement and fewer participants with no change or deterioration compared with the STREAM-15. Limitations. Few patients with subacute stroke showed deterioration at discharge, so the abilities of the 2 measures to detect deterioration remain inconclusive. Conclusions. The STREAM-27 detected more participants with significant recovery compared with the STREAM-15, although the group-level responsiveness of the 2 measures was the same. The STREAM-27 is recommended as an outcome measure to demonstrate the treatment effects of movement and mobility for patients with stroke.
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U2 - 10.2522/ptj.20140331
DO - 10.2522/ptj.20140331
M3 - Article
C2 - 25744276
AN - SCOPUS:84938595228
SN - 0031-9023
VL - 95
SP - 1172
EP - 1183
JO - Physical therapy
JF - Physical therapy
IS - 8
ER -