Objective: (1) To develop an ordinal scale (content validity) for assessing ‘uidity of the rise-to-walk task (RTW); (2) to examine the concurrent validity of the ‘uidity 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 ‘uidity scale and the ‘uidity 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 ‘uidity index (FI) and the scores from the ‘uidity scale; for the inter-rater reliability study: duration of the RTW task and ‘uidity scores.
Results: The FI values did not overlap across categories of the scale and the relationship between FI values and the ‘uidity scores was 0.99. The weighted kappa (kw) indicated a substantial level of agreement between the new raters (kw = 0.78) and between the new raters and the expert rater (kw = 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 ‘uidity comparable to the gold standard measure (FI) and that trained clinicians can use the ‘uidity 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.
Get full access to this article
View all access options for this article.
References
1.
Engardt M, Olsson E. Body weight-bearing while rising and sitting down in patients with stroke. Scand J Rehabil Med1992; 24: 67–74.
2.
Hesse S, Schauer M, Malezic M, Jahnke M, Mauritz KH. Quantitative analysis of rising from a chair in healthy and hemiparetic subjects. Scand J Rehabil Med1994; 26: 161–166.
3.
Brunt D, Vander Linden DW, Behrman AL. The relation between limb loading and control parameters of gait initiation in persons with stroke. Arch Phys Med Rehabil1995; 76: 627–634.
4.
Podsiadlo D, Richardson S. The Timed ‘Up and Go’: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc1991; 39: 142–148.
5.
Roorda L, Roebroeck M, Lankhorst G, Van Tilburg T, Bouter L. Measuring functional limitations in rising and sitting down: development of a questionnaire. Arch Phys Med Rehabil1996; 77: 663–669.
6.
Isaacs B. Clinical and laboratory studies of falls in old people. Clin Geriatr Med1985; 1: 513–524.
7.
Dion L. Élaboration et validation d'un test clinique pour évaluer la capacité des sujets cérébrolésés à exécuter la tâche ‘se lever pour marcher’. MSc thesis (#19362), Laval University, Quebec City, Canada, August 2001.
8.
Malouin F, Dion L, McFadyen B, Richards CL, St-Vincent G. Changes in the ‘uidity of the rise-to-walk motor strategy after stroke. In: Duysens J, Smits-Engelsman BCM, Kingma H eds. Control of posture and gait. Symposium of the International Society for Postural and Gait Research SPG, Maastrich, The Netherlands, 2001: 671–674.
9.
Dion L, Malouin F, McFadyen, BJ, Richards CL. The Rise-To-Walk task for assessing mobility and locomotor co-ordination after stroke. Neurorehabil Neural Repair2003; 17: 83–92.
10.
Dion L, Malouin F, McFadyen BJ, Richards CL. Modification of the sit-to-walk task after stroke. Soc Neurosci1999; 25: abstract 365.2.
11.
Magnan A, McFadyen BJ, St-Vincent G. Modification of the sit-to stand task with the addition of gait initiation. Gait Posture1996; 4: 232–241.
12.
Salbach M, Mayo NE, Higgins J, Ahmed S, Finch LE, Richards CL. Responsiveness and predictability of gait speed and other disability measures in acute stroke. Arch Phys Med Rehabil2001; 82: 1204–1212.
13.
Berg KO, Wood-Dauphinee SL, Williams JI, Gayton D. Measuring balance in the elderly: preliminary development of an instrument. Physiother Can1989; 41: 304–311.
14.
Fugl-Meyer AR, Jääskö L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient I, a method for evaluation of physical performance. Scand J Rehabil Med1975; 7:13–31.
15.
Landis JR Koch GG. The measurement of observer A ‘uidity scale the rise-to-walk task 683 agreement for categorical data. Biometrics1976; 33: 159–174.
16.
Cohen J. Weighted Kappa: nominal scale agreement with provision for scaled disagreement or partial credit. Psychol Bull1968; 70: 213–220
17.
Fleiss JL. The design and analysis of clinical experiments. New York: Wiley, 1985.
18.
Shumway-Cook A, Woollacott MH. Motor control. theory and practical applications, second edition. Baltimore: Williams and Wilkins, 2001.
19.
Carr J, Shepherd, R. Neurological rehabilitation: optimizing motor performance. London: Butterworth Heinemann, 1998.
20.
Streiner DL, Norman GR. Health measurements scales. a practical guide to their development and use, second edition. New York: Oxford University Press, 1995: 231-231.
21.
Goodwin R, Diller L. Reliability among physical therapists in diagnosis and treatment of gait deviations in hemiplegics. Percept Motor Skill1973; 37: 727–734.
