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A fluidity scale for evaluating the motor strategy of the rise-to-walk task after stroke

Bradford McFadyen

Lise Dion

Carol L Richards

Department of Rehabilitation, Faculty of Medicine, Laval University and Centre for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Canada

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 (k_w) indicated a substantial level of agreement between the new raters (k_w = 0.78) and between the new raters and the expert rater (k_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 ‘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.

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