Comparison of the Responsiveness of the Long-Form and Simplified Stroke Rehabilitation Assessment of Movement: Group- and Individual-Level Analysis. Issue 8 (1st August 2015)

• Record Type: Journal Article
• Authors: Huang, Yi-Jing; Chen, Kuan-Lin; Chou, Yeh-Tai; Hsueh, I-Ping; Hou, Chieh-Yi; Hsieh, Ching-Lin
• Is Part Of: Physical therapy. Volume 95:Issue 8(2015)
• Page Start: 1172
• Page End: 1183
• Publication Date: 2015-08-01
• Subjects: Physical therapy -- Periodicals; Physical therapy; Physical Therapy Modalities; Rehabilitation; Physical and Rehabilitation Medicine; Periodicals; 615.8205
• DOI: 10.2522/ptj.20140331
• Languages: English
• ISSNs: 0031-9023

Abstract

Abstract : 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.