The Modified Version of the Postural Assessment Scale for Stroke Patients (SwePASS) Measurement properties and a longitudinal follow-up

The Modified Version of the Postural Assessment Scale for Stroke Patients (SwePASS)

Measurement properties and a longitudinal follow-up Carina  U  Persson  

Institute  of  Neuroscience  and  Physiology   Department  of  Clinical  Neuroscience  and  Rehabilitation   The  Sahlgrenska  Academy  at  the  University  of  Gothenburg    

Göteborg,  Sweden  

ABSTRACT

Aims:   The   aim   of   this   thesis   was   to   evaluate   the   measurement   properties   of   the   Modified   Version   of   the   Postural   Assessment   Scale   for   Stroke   Patients   (SwePASS)   and   to   estimate   the   longitudinal   change   in   postural   control   during   the   first   12   months  after  stroke.  

Methods:   A   total   of   152   patients   with   first-­‐ever   stroke   participated   in   the   studies   included   in   the   thesis,   and   116   of   these   patients   participated   in   a   prospective   follow-­‐up  with  repeated  assessments  of  postural  control  and  questioners  relating  to   falls  at  three,  six  and  12  months.  

Results:  The  SwePASS  proved  to  be  highly  reliable  and  responsive  to  change.  Used   in  the  first  week  after  stroke  onset,  the  SwePASS  is  able  to  identify  those  patients  at   risk   of   falling   during   the   first   year   after   stroke   moderately   well.   Postural   control,   assessed   using   the   SwePASS,   shows   an   improvement   during   the   first   six   months   after   stroke.   Rasch   analysis   of   the   SwePASS   indicates   that   it   works   as   a   global   measurement   of   postural   control   in   patients   with   stroke   but   displays   disordered   thresholds   and   local   dependency.   Further   studies,   with   larger   populations,   are   needed  to  confirm  these  results.    

Conclusions:   To   summarise,   the   results   of   the   measurement   properties   of   the   SwePASS   indicate   that   this   scale   is   useful   in   the   clinical   setting   for   patients   with   stroke.    

Keywords:  postural  balance,  stroke,  outcome    

ISBN:  978-­‐91-­‐628-­‐8536-­‐6  

The Modified Version of the Postural Assessment Scale for Stroke Patients (SwePASS)

Measurement properties and a longitudinal follow-up

Akademisk  avhandling    

som  för  avläggande  av  medicine  doktorsexamen     vid  Sahlgrenska  akademin  vid  Göteborgs  universitet     kommer  att  offentligen  försvaras  i  hörsal  Arvid  Carlsson,    

Academicum,  Medicinaregatan  13,     fredagen  den  7  december  2012    

kl  09.30   av    

  Carina  U  Persson   Leg.  Sjukgymnast,  MSc  

Fakultetsopponent     Professor  Karin  Harms-­‐Ringdahl    

Institutionen  för  neurobiologi,  vårdvetenskap  och  samhälle   Sektionen  för  sjukgymnastik,  Karolinska  Institutet,    

Huddinge,  Stockholm.  

This  thesis  is  based  on  the  following  papers:    

  I. Persson  C  U,  Hansson  P-­‐O,  Danielsson  A,  Sunnerhagen  K  S.  A  validation  study  using   a  modified  version  of  Postural  Assessment  Scale  for  Stroke  Patients:  Postural   Stroke  Study  in  Gothenburg  (POSTGOT).    

J  Neuroeng  Rehabil  2011  8:57.  

II.   Persson  C  U,  Hansson  P-­‐O,  Sunnerhagen  K  S.  Clinical  tests  performed  in  acute   stroke  identify  the  risk  of  falling  during  the  first  year:  Postural  Stroke  Study  in   Gothenburg  (POSTGOT).    

J  Rehabil  Med  2011;  43:  348-­‐53.  

III.   Persson  C  U,  Sunnerhagen  K  S,  Danielsson  A,  Grimby-­‐Ekman  A,  Hansson  P-­‐O.  

Responsiveness  of  a  modified  version  of  the  Postural  Assessment  Scale  for  Stroke   Patients  and  longitudinal  change  in  postural  control  after  stroke:    Postural  Stroke  Study   in  Gothenburg  (POSTGOT).    

  J  Neuroeng  Rehabil  Accepted  for  publication.  

IV.     Persson  C  U,  Sunnerhagen  K  S,  Lundgren-­‐Nilsson  Å.    

Rasch  analysis  of  the  Modified  Version  of  the  Postural  Assessment  Scale  for  Stroke   Patients:  Postural  Stroke  Study  in  Gothenburg  (POSTGOT)  

Submitted.