Fujii A1, Shimada D2, Shishido K2
1YIC Rehabilitation College, Ube, Japan, 2Itsukaichi Memorial Hospital, Rehabilitation Tech., Hiroshima, Japan
Background: To make a comparative review of variety of Assessments for Stroke will be make clarify of these clinical importance and problems for practice of Evidence-based Physical Therapy.
Purpose: To validate the reliabilities and validities of the Chedoke-McMaster Stroke Assessment（CMSA）in Japan
Methods: The subjects of this study were15 stroke patients after 3 month from onset. (12 male and 3 female mean age were 70.07±8.29 yrs ) All of the subjects were required for stabilization of their neurological condition. The subjects were examined by 3 physical therapists using CMSA. CMSA is consists of 7 tests, Upper Extremity, Fingers, Lower Extremity, Shoulder Pain, Posture Control, Foot and Disability Inventory. These data were compared for verifying the inter-rater reliability of CMSA. These data were also compared with Brunnstrom Recovery Stage(BRS), Functional Balance Scale(FBS), Timed Up and Go Test(TUG), 10 meter maximal walk speed(10mMWS), Barthel Index(BI) and Functional Independence Measure(FIM) for verifying the validities of CMSA. Analysis: Kappa coefficient, Kendall´s coefficient of concordance, correlation coefficient, Spearman´s rank correlation coefficient.
Results: As the reliabilities: Comparing with data of CMSA examined by 2 physical therapists using Kappa coefficient were showed high and very high reproducibility (κ＝0.65116-0.83146) Comparing with 3 physical therapists using by Kendall´s coefficient of concordance were showed consistent statics only upper extremity test of CMSA. (W＝0.35238)
As the validities: Those were found to have a strong correlations in CMSA and BRS(0.897-0.921, p 0.01), Posture control of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.817-0.921, p 0.01), Upper extremity of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.764-0.863, p 0.01), Disability Inventory of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.774～0.955, p 0.01).
Conclusion(s): This study showed only inter-rater reliability of 2 physical therapists, couldn't show inter-rater reliability among 3 physical therapists. The reasons of these were thought motor leaning of subjects, fatigue of subjects and different of measurement by examiner. The validities of CMSA were showed as same as BRS which commonly used Japanese physical therapist. There is the significance to examine to use CMSA by physical therapists because which can also evaluate Shoulder Pain, Posture Control, Foot and Disability Inventory.
Implications: CMSA is not common assessment for stroke in Japan but this study showed these reliabilities and validities. It's expected to use CMSA for prognostic predictor of stroke as an outcome measure to practice for Evidence-Based Physical Therapy.
Keywords: The Chedoke-McMaster Stroke Assessment, Reliabilities & Validities, stroke in Japan
Funding acknowledgements: None
Purpose: To validate the reliabilities and validities of the Chedoke-McMaster Stroke Assessment（CMSA）in Japan
Methods: The subjects of this study were15 stroke patients after 3 month from onset. (12 male and 3 female mean age were 70.07±8.29 yrs ) All of the subjects were required for stabilization of their neurological condition. The subjects were examined by 3 physical therapists using CMSA. CMSA is consists of 7 tests, Upper Extremity, Fingers, Lower Extremity, Shoulder Pain, Posture Control, Foot and Disability Inventory. These data were compared for verifying the inter-rater reliability of CMSA. These data were also compared with Brunnstrom Recovery Stage(BRS), Functional Balance Scale(FBS), Timed Up and Go Test(TUG), 10 meter maximal walk speed(10mMWS), Barthel Index(BI) and Functional Independence Measure(FIM) for verifying the validities of CMSA. Analysis: Kappa coefficient, Kendall´s coefficient of concordance, correlation coefficient, Spearman´s rank correlation coefficient.
Results: As the reliabilities: Comparing with data of CMSA examined by 2 physical therapists using Kappa coefficient were showed high and very high reproducibility (κ＝0.65116-0.83146) Comparing with 3 physical therapists using by Kendall´s coefficient of concordance were showed consistent statics only upper extremity test of CMSA. (W＝0.35238)
As the validities: Those were found to have a strong correlations in CMSA and BRS(0.897-0.921, p 0.01), Posture control of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.817-0.921, p 0.01), Upper extremity of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.764-0.863, p 0.01), Disability Inventory of CMSA and FBS, TUG, 10mMWS, BI, FIM(0.774～0.955, p 0.01).
Conclusion(s): This study showed only inter-rater reliability of 2 physical therapists, couldn't show inter-rater reliability among 3 physical therapists. The reasons of these were thought motor leaning of subjects, fatigue of subjects and different of measurement by examiner. The validities of CMSA were showed as same as BRS which commonly used Japanese physical therapist. There is the significance to examine to use CMSA by physical therapists because which can also evaluate Shoulder Pain, Posture Control, Foot and Disability Inventory.
Implications: CMSA is not common assessment for stroke in Japan but this study showed these reliabilities and validities. It's expected to use CMSA for prognostic predictor of stroke as an outcome measure to practice for Evidence-Based Physical Therapy.
Keywords: The Chedoke-McMaster Stroke Assessment, Reliabilities & Validities, stroke in Japan
Funding acknowledgements: None
Topic: Neurology: stroke; Neurology
Ethics approval required: Yes
Institution: Yamaguchi University
Ethics committee: Yamaguchi University Ethical Review Board
Ethics number: 20101203
All authors, affiliations and abstracts have been published as submitted.
