Rate of perceived stability as a measure of balance exercise intensity in people post-stroke

Figures & data

Figure 1. Relationships between rate of perceived stability [10] (RPS) and rating of perceived challenge [14] (RPS:RPC), measure of performance (RPS:Perf). Spearman correlation coefficients (r_s) were calculated between RPS and the individual task scoring on each of the CB&M tasks (example of unilateral stance task provided), 6MWT (distance walked) and self-selected gait speed to explore associations between RPS and task performance (RPS:Perf). Spearman correlation coefficients (r_s) were calculated between self-reported ratings on the RPS and RPC to explore the relationships between perception of stability and generalized challenge while performing balance and mobility tasks (RPS:RPC).

The Rate of Perceived Stability (RPS) Scale is shown including description for scores from 1–10. The Rate of Perceived Challenge (RPC) Scale is shown including description of scores from 0–10. Finally, an item of the Community Balance and Mobility (CB&M) Scale is shown. The task item shown is unilateral stance and its performance scores are shown from 0–5 with description of scoring. A picture of a stick figure is shown in single leg stance representative of unilateral stance. Arrows between RPS and RPC scales demonstrate the exploration of relationship between these two measures. Arrows between the RPS and the CB&M Scale performance rating represent the investigation of relationship between RPS task score and CB&M performance score.

Table 1. Clinical characteristics.

Participant characteristics	Females	Males
Age (year, mean (SD)	65.5 (9.7)	65.1 (10.2)
Time since stroke (years, mean (SD)	7.6 (5.9)	9.4 (4.7)
Type of stroke (Ischaemic/haemorrhagic/unknown)	9/4/1	10/4
Hemiparetic side (right/left)	7R/7L	6R/8L
Use of Walking Aid (none/cane or pole/walker)	8/4/2	5/9/0
Ankle-foot orthosis (none/fixed/flexible)	9/1/4	10/2/2
Clinical measures^a
ABC (/100)	66.3 (20.8)	81.9 (13.6)
CMSA (foot/leg)	4.5 (2)/5.8 (1.3)	4.3 (2)/5.2 (1.6)
Self-paced gait speed (m/s)	0.7 (0.3)	0.8 (0.2)
6MWT distance walked (m)	283.2 (109.6)	329.3 (129.4)
Modified CB&M total score (/80)	26.8 (12.8)	25.7 (1.5)

^aAll clinical measures results presented as mean (SD).

Table 2. Rate of perceived stability (RPS) for each task (mean (SD) for day 1 and 2, and between day intraclass correlations (ICC), standard error of measurement (SEM (% mean) and smallest detectable change (SDC (% mean).

Task	RPS Day 1	RPS Day 2	ICC^a	95% CI	p-Value	SEM^b	SDC^b
CB&M tasks
Unilateral Stance Non-Paretic	6 (2)	5 (2)	0.64	0.23–0.84	0.002	1 (18%)	4 (73%)
Unilateral Stance Paretic	8 (2)	7 (2)	0.80	0.56–0.90	<0.001	1 (13%)	3 (40%)
Tandem Walking	7 (2)	6 (2)	0.80	0.55–0.91	<0.001	1 (15%)	3 (46%)
180 Tandem Pivot	7 (2)	7 (2)	0.69	0.34–0.86	0.001	1 (14%)	3 (43%)
Lateral Foot Scooting Non-Paretic	8 (2)	7 (2)	0.84	0.64–0.93	<0.001	1 (13%)	2 (27%)
Lateral Foot Scooting Paretic	9 (2)	9 (1)	0.77	0.47–0.90	<0.001	1 (11%)	2 (22%)
Hopping Forward Non-Paretic	8 (2)	7 (2)	0.91	0.80–0.96	<0.001	1 (13%)	2 (27%)
Hopping Forward Paretic	9 (2)	9 (2)	0.87	0.71–0.94	<0.001	1 (11%)	2 (22%)
Crouch and Walk (pick up objects from floor)	4 (2)	4 (2)	0.62	0.19–0.82	0.003	1 (25%)	3 (75%)
Lateral Dodging (cross-over steps)	7 (3)	6 (3)	0.92	0.82–0.97	<0.001	1 (15%)	2 (29%)
Walking and Looking Right	4 (2)	4 (2)	0.61	0.15–0.82	0.009	1 (25%)	4 (100%)
Walking and Looking Left	4 (2)	4 (2)	0.63	0.17–0.83	0.008	1 (25%)	3 (75%)
Running with Controlled Stop	4 (2)	4 (2)	0.86	0.69–0.93	<0.001	1 (25%)	2 (50%)
Forward to Backward Walking	4 (2)	4 (2)	0.46	−0.20–0.75	0.064	1 (25%)	4 (100%)
Step ups Non-Paretic	6 (3)	6 (3)	0.93	0.84–0.97	<0.001	1 (17%)	2 (33%)
Step ups Paretic	6 (3)	6 (2)	0.87	0.69–0.95	<0.001	1 (17%)	3 (50%)
Measures of walking ability
Self-selected Gait Speed Test	3 (2)	2 (1)	0.56	0.09–0.79	0.009	1 (40%)	3 (100%)
6MWT at 3-minute mark	3 (2)	3 (2)	0.84	0.65–0.93	<0.001	1 (33%)	2 (67%)
6MWT at 6-minute mark	3 (2)	3 (2)	0.77	0.49–0.90	<0.001	1 (33%)	3 (100%)

^aNon-significant task ICC results are italicized.

^bSEM and SDC presented with percentage of mean score calculated from RPS Day 1 and 2 scores.

Table 3. Correlation coefficients between rate of perceived stability (RPS) and rating of perceived challenge (RPS:RPC), measure of performance (RPS:Perf).

Task	RPS:RPC (rs)	p-Value	RPS:Perf (rs)^a	p-Value
CB&M tasks
Unilateral Stance Non-Paretic	0.78	<0.001	−0.58	0.001
Unilateral Stance Paretic	0.83	<0.001	−0.46	0.010
Tandem Walking	0.87	<0.001	−0.36	0.058
180 Tandem Pivot	0.83	<0.001	−0.36	0.061
Lateral Foot Scooting Non-Paretic	0.81	<0.001	−0.53	0.004
Lateral Foot Scooting Paretic	0.85	<0.001	−0.53	0.005
Hopping Forward Non-Paretic	0.85	<0.001	−0.51	0.006
Hopping Forward Paretic	0.91	<0.001	−0.57	0.003
Crouch and Walk (pick up objects from floor)	0.82	<0.001	−0.16	0.425
Lateral Dodging (cross-over steps)	0.94	<0.001	−0.81	<0.001
Walking and Looking Right	0.81	<0.001	−0.32	0.099
Walking and Looking Left	0.88	<0.001	−0.27	0.169
Running with Controlled Stop	0.92	<0.001	−0.49	0.008
Forward to Backward Walking	0.89	<0.001	−0.35	0.069
Step ups Non-Paretic	0.92	<0.001	−0.72	<0.001
Step ups Paretic	0.90	<0.001	−0.61	0.002
Measures of walking ability
Self-selected Gait Speed Test	0.53	0.003	−0.26^b	0.179
6MWT at 3-minute mark	0.74	<0.001	na	na
6MWT at 6-minute mark	0.84	<0.001	−0.55^c	0.003

^aNon-significant association between RPS and performance scores are italicized.

^bAssociation between RPS and walking speed during the self-paced gait speed test (m/s).

^cAssociation between RPS and distance walked during the 6MWT (m).

Persky RW, Turtzo LC, McCullough LD. Stroke in women: disparities and outcomes. Curr Cardiol Rep. 2010;12(1):6–13.

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Hendricks S, Till K, Oliver JL, et al. Rating of perceived challenge as a measure of internal load for technical skill performance. Br J Sports Med. 2019;53(10):611–613.

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