Skip to main content
Top
Published in: BMC Neurology 1/2014

Open Access 01-12-2014 | Research article

Rasch analysis of the modified version of the Postural Assessment Scale for Stroke patients: Postural Stroke Study in Gothenburg (POSTGOT)

Authors: Carina U Persson, Katharina S Sunnerhagen, Åsa Lundgren-Nilsson

Published in: BMC Neurology | Issue 1/2014

Login to get access

Abstract

Background

The modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) is a new ordinal outcome measurement designed to assess postural control in patients with stroke. Before implementation of SwePASS into the clinical setting, it is necessary to know its measurement properties. Thus, the aim of the study was to evaluate the measurement properties of the SwePASS.

Methods

Rasch analysis, based on data of 150 SwePASS assessments was made the first week after stroke onset. The measurement properties referred to were unidimensionality, local independence, invariance, category function, targeting of persons and items and the reliability.

Results

The initial analysis showed disordered thresholds in four items. After adjustment of the scoring categories, this was resolved. However, analyses of local dependency revealed correlations between two of the items. These two items were collapsed into one. After adjustments, the person separation index that acts as an indicator of the whole model fit was 0.96. The adjusted SwePASS is a global scale that works the same way regardless of gender, age and location of stroke lesion. Overall, the population had better postural control than was targeted with the items in the scale.

Conclusions

Rasch analysis of the adjusted SwePASS showed that the scale was unidimensional. In SwePASS, equal capacity in postural control provides the same response to an individual item in patients with stroke, regardless of gender, age and location of stroke lesion. Regarding clinical implications, before introducing SwePASS in clinical routine and to confirm the results, further research including a larger sample with poorer postural control is suggested.
Appendix
Available only for authorised users
Literature
1.
go back to reference Persson CU, Hansson PO, Danielsson A, Sunnerhagen KS: A validation study using a modified version of the postural assessment scale for stroke patients: Postural Stroke Study in Gothenburg (POSTGOT). J Neuroeng Rehabil. 2011, 8: 57-10.1186/1743-0003-8-57.CrossRefPubMedPubMedCentral Persson CU, Hansson PO, Danielsson A, Sunnerhagen KS: A validation study using a modified version of the postural assessment scale for stroke patients: Postural Stroke Study in Gothenburg (POSTGOT). J Neuroeng Rehabil. 2011, 8: 57-10.1186/1743-0003-8-57.CrossRefPubMedPubMedCentral
2.
go back to reference Persson CU, Hansson PO, Sunnerhagen KS: 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: 348-353. 10.2340/16501977-0677.CrossRefPubMed Persson CU, Hansson PO, Sunnerhagen KS: 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: 348-353. 10.2340/16501977-0677.CrossRefPubMed
3.
go back to reference Benaim C, Perennou DA, Villy J, Rousseaux M, Pelissier JY: Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999, 30: 1862-1868. 10.1161/01.STR.30.9.1862.CrossRefPubMed Benaim C, Perennou DA, Villy J, Rousseaux M, Pelissier JY: Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke. 1999, 30: 1862-1868. 10.1161/01.STR.30.9.1862.CrossRefPubMed
4.
go back to reference Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S: The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975, 7: 13-31.PubMed Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S: The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975, 7: 13-31.PubMed
5.
go back to reference Lindmark B, Hamrin E: Evaluation of functional capacity after stroke as a basis for active intervention. Presentation of a modified chart for motor capacity assessment and its reliability. Scand J Rehabil Med. 1988, 20: 103-109.PubMed Lindmark B, Hamrin E: Evaluation of functional capacity after stroke as a basis for active intervention. Presentation of a modified chart for motor capacity assessment and its reliability. Scand J Rehabil Med. 1988, 20: 103-109.PubMed
6.
go back to reference Persson CU, Danielsson A, Grimby-Ekman A, Hansson PO: 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. 2013, 10: 8-10.1186/1743-0003-10-8.CrossRefPubMedPubMedCentral Persson CU, Danielsson A, Grimby-Ekman A, Hansson PO: 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. 2013, 10: 8-10.1186/1743-0003-10-8.CrossRefPubMedPubMedCentral
7.
go back to reference Probabilistic models for some intelligence and attainment tests. Edited by: Rasch G. 1960, Chicago: University of Chicago Press Probabilistic models for some intelligence and attainment tests. Edited by: Rasch G. 1960, Chicago: University of Chicago Press
8.
go back to reference Wright BD, Linacre JM: Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil. 1989, 70: 857-860.PubMed Wright BD, Linacre JM: Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil. 1989, 70: 857-860.PubMed
9.
go back to reference Silverstein B, Fisher WP, Kilgore KM, Harley JP, Harvey RF: Applying psychometric criteria to functional assessment in medical rehabilitation: II. Defining interval measures. Arch Phys Med Rehabil. 1992, 73: 507-518.PubMed Silverstein B, Fisher WP, Kilgore KM, Harley JP, Harvey RF: Applying psychometric criteria to functional assessment in medical rehabilitation: II. Defining interval measures. Arch Phys Med Rehabil. 1992, 73: 507-518.PubMed
10.
go back to reference Lundgren Nilsson A, Tennant A: Past and present issues in Rasch analysis: the functional independence measure (FIM) revisited. J Rehabil Med. 2011, 43: 884-891.CrossRefPubMed Lundgren Nilsson A, Tennant A: Past and present issues in Rasch analysis: the functional independence measure (FIM) revisited. J Rehabil Med. 2011, 43: 884-891.CrossRefPubMed
11.
go back to reference Stroke–1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke. 1989, 20: 1407-1431. Stroke–1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke. 1989, 20: 1407-1431.
12.
go back to reference Puri KS, Suresh KR, Gogtay NJ, Thatte UM: Declaration of Helsinki, 2008: implications for stakeholders in research. J Postgrad Med. 2009, 55: 131-134. 10.4103/0022-3859.52846.CrossRefPubMed Puri KS, Suresh KR, Gogtay NJ, Thatte UM: Declaration of Helsinki, 2008: implications for stakeholders in research. J Postgrad Med. 2009, 55: 131-134. 10.4103/0022-3859.52846.CrossRefPubMed
13.
go back to reference Glader EL, Sjolander M, Eriksson M, Lundberg M: Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke. Stroke. 2010, 41: 397-401. 10.1161/STROKEAHA.109.566950.CrossRefPubMed Glader EL, Sjolander M, Eriksson M, Lundberg M: Persistent use of secondary preventive drugs declines rapidly during the first 2 years after stroke. Stroke. 2010, 41: 397-401. 10.1161/STROKEAHA.109.566950.CrossRefPubMed
14.
go back to reference Andrich D, Lyne A, Sheridan B, Luo G: RUMM2030. 2010, Western Australia: Australia: Perth: RUMM Laboratory Pty Ltd, 32- Andrich D, Lyne A, Sheridan B, Luo G: RUMM2030. 2010, Western Australia: Australia: Perth: RUMM Laboratory Pty Ltd, 32-
15.
go back to reference Smith EV: Detecting and evaluating the impact of multidimensionality using item fit statistics and principal component analysis of residuals. J Appl Meas. 2002, 3: 205-231.PubMed Smith EV: Detecting and evaluating the impact of multidimensionality using item fit statistics and principal component analysis of residuals. J Appl Meas. 2002, 3: 205-231.PubMed
16.
go back to reference Bhakta B, Tennant A, Horton M, Lawton G, Andrich D: Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education. BMC Med Educ. 2005, 5: 9-10.1186/1472-6920-5-9.CrossRefPubMedPubMedCentral Bhakta B, Tennant A, Horton M, Lawton G, Andrich D: Using item response theory to explore the psychometric properties of extended matching questions examination in undergraduate medical education. BMC Med Educ. 2005, 5: 9-10.1186/1472-6920-5-9.CrossRefPubMedPubMedCentral
17.
go back to reference Rasch models for measurement. Quantitative Applications in the Social Sciences. Edited by: Andrich D. 1988, London: Sage Publications Rasch models for measurement. Quantitative Applications in the Social Sciences. Edited by: Andrich D. 1988, London: Sage Publications
19.
go back to reference Tennant A, Conaghan PG: The Rasch measurement model in rheumatology: what is it and why use it? When should it be applied, and what should one look for in a Rasch paper?. Arthritis Rheum. 2007, 57: 1358-1362. 10.1002/art.23108.CrossRefPubMed Tennant A, Conaghan PG: The Rasch measurement model in rheumatology: what is it and why use it? When should it be applied, and what should one look for in a Rasch paper?. Arthritis Rheum. 2007, 57: 1358-1362. 10.1002/art.23108.CrossRefPubMed
20.
go back to reference Marais I, Andrich D: Formalizing dimension and response violations of local independence in the unidimensional Rasch model. J Appl Meas. 2008, 9: 200-215.PubMed Marais I, Andrich D: Formalizing dimension and response violations of local independence in the unidimensional Rasch model. J Appl Meas. 2008, 9: 200-215.PubMed
21.
go back to reference Holland P, Wainer H: Differential Item Functioning. 1993, NJ, Hollsdale: Lawrence Erlbaum Holland P, Wainer H: Differential Item Functioning. 1993, NJ, Hollsdale: Lawrence Erlbaum
22.
go back to reference Hagquist C, Bruce M, Gustavsson JP: Using the Rasch model in nursing research: an introduction and illustrative example. Int J Nurs Stud. 2009, 46: 380-393. 10.1016/j.ijnurstu.2008.10.007.CrossRefPubMed Hagquist C, Bruce M, Gustavsson JP: Using the Rasch model in nursing research: an introduction and illustrative example. Int J Nurs Stud. 2009, 46: 380-393. 10.1016/j.ijnurstu.2008.10.007.CrossRefPubMed
23.
go back to reference Pallant JF, Tennant A: An introduction to the Rasch measurement model: an example using the Hospital Anxiety and Depression Scale (HADS). Br J Clin Psychol. 2007, 46: 1-18. 10.1348/014466506X96931.CrossRefPubMed Pallant JF, Tennant A: An introduction to the Rasch measurement model: an example using the Hospital Anxiety and Depression Scale (HADS). Br J Clin Psychol. 2007, 46: 1-18. 10.1348/014466506X96931.CrossRefPubMed
24.
go back to reference Hobart JC, Cano SJ, Zajicek JP, Thompson AJ: Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. Lancet Neurol. 2007, 6: 1094-1105. 10.1016/S1474-4422(07)70290-9.CrossRefPubMed Hobart JC, Cano SJ, Zajicek JP, Thompson AJ: Rating scales as outcome measures for clinical trials in neurology: problems, solutions, and recommendations. Lancet Neurol. 2007, 6: 1094-1105. 10.1016/S1474-4422(07)70290-9.CrossRefPubMed
25.
go back to reference La Porta F, Caselli S, Susassi S, Cavallini P, Tennant A, Franceschini M: Is the berg balance scale an internally valid and reliable measure of balance across different etiologies in neurorehabilitation? A revisited Rasch analysis study. Arch Phys Med Rehabil. 2012, 93 (7): 1209-16. 10.1016/j.apmr.2012.02.020.CrossRefPubMed La Porta F, Caselli S, Susassi S, Cavallini P, Tennant A, Franceschini M: Is the berg balance scale an internally valid and reliable measure of balance across different etiologies in neurorehabilitation? A revisited Rasch analysis study. Arch Phys Med Rehabil. 2012, 93 (7): 1209-16. 10.1016/j.apmr.2012.02.020.CrossRefPubMed
26.
go back to reference Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL: Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992, 73: 1073-1080.PubMed Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL: Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil. 1992, 73: 1073-1080.PubMed
27.
go back to reference Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992, 83 (Suppl 2): S7-S11.PubMed Berg KO, Wood-Dauphinee SL, Williams JI, Maki B: Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992, 83 (Suppl 2): S7-S11.PubMed
28.
go back to reference Linacre JM: Investigating rating scale category utility. J Outcome Meas. 1999, 3: 103-122.PubMed Linacre JM: Investigating rating scale category utility. J Outcome Meas. 1999, 3: 103-122.PubMed
30.
go back to reference Tyson SF, Connell LA: How to measure balance in clinical practice. A systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions. Clin Rehabil. 2009, 23: 824-840. 10.1177/0269215509335018.CrossRefPubMed Tyson SF, Connell LA: How to measure balance in clinical practice. A systematic review of the psychometrics and clinical utility of measures of balance activity for neurological conditions. Clin Rehabil. 2009, 23: 824-840. 10.1177/0269215509335018.CrossRefPubMed
31.
go back to reference Franchignoni F, Horak F, Godi M, Nardone A, Giordano A: Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010, 42: 323-331. 10.2340/16501977-0537.CrossRefPubMedPubMedCentral Franchignoni F, Horak F, Godi M, Nardone A, Giordano A: Using psychometric techniques to improve the Balance Evaluation Systems Test: the mini-BESTest. J Rehabil Med. 2010, 42: 323-331. 10.2340/16501977-0537.CrossRefPubMedPubMedCentral
32.
go back to reference La Porta F, Franceschini M, Caselli S, Cavallini P, Susassi S, Tennant A: Unified Balance Scale: an activity-based, bed to community, and aetiology-independent measure of balance calibrated with Rasch analysis. J Rehabil Med. 2011, 43: 435-444. 10.2340/16501977-0797.CrossRefPubMed La Porta F, Franceschini M, Caselli S, Cavallini P, Susassi S, Tennant A: Unified Balance Scale: an activity-based, bed to community, and aetiology-independent measure of balance calibrated with Rasch analysis. J Rehabil Med. 2011, 43: 435-444. 10.2340/16501977-0797.CrossRefPubMed
Metadata
Title
Rasch analysis of the modified version of the Postural Assessment Scale for Stroke patients: Postural Stroke Study in Gothenburg (POSTGOT)
Authors
Carina U Persson
Katharina S Sunnerhagen
Åsa Lundgren-Nilsson
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2014
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/1471-2377-14-134

Other articles of this Issue 1/2014

BMC Neurology 1/2014 Go to the issue