The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability

Abstract

Background: To translate the Modified Swedish version of Postural Assessment Scale for Stroke (SwePASS) into Norwegian (SwePASS-NV) and assess its intra- and interrater reliability.

Methods: Translation and cross-cultural adaptation was accomplished according to international guidelines. Forty-seven adults, suffering a stroke within the last 6 months, were strategically recruited and allocated into groups according to five different levels of function. Their performance on SwePASS-NV was video-recorded and then scored by three raters twice, with a minimum of 4 weeks between sessions. Relative reliability was investigated by calculating intraclass correlation coefficients (ICC_1.1 and ICC_3.1). Absolute reliability was analysed using within-subject SD (S_w) and smallest detectable difference (SDD). For individual items, Cohen’s kappa (k) and percentage of agreement were calculated.

Results: The study showed excellent intra- and interrater reliability (ICC_1.1 and ICC_3.1 ≥0.99) for SwePASS-NV. K-values for the individual items ranged between 0.68 and 1.00. Percentages of agreement ranged from 77% to 100%. SDD at 95% confidence interval was ≤2 points for intrarater assessments and ≤3 points for interrater assessments.

Conclusions: This study demonstrated very high intra- and interrater reliability of the SwePASS-NV in adults within the first 6 months after stroke. All items showed very high or high agreement.

Keywords:

• SwePASS-Norwegian version
• intrarater reliability
• interrater reliability
• balance
• balance measure
• stroke

Acknowledgements

The authors thank the people with stroke who participated in the study and thereby provided the data used for the analyses. In addition, we wish to thank Hedda Døli, Anne Mette Gravaas Berget and Inger Crook Hummelsund for their participation in the translation process, and to Joseph Greenshields for back-translating the SwePASS-NV. The authors also wish to express gratitude to the following persons who made the study possible; Torunn Grenstad, Helene Christiansen, Ingjerd Opheim, Sissel-Aina Brenne, Eli Olsen and Henninge Milde (testers); Annette Memelink Iversen (research assistant) and the raters Silje Daltveit, Veronica Bøe and Rikke Sem Olsen. Moreover, we thank the Department of Physiotherapy and the Department of Physical Medicine and Rehabilitation at Haukeland University Hospital. This study was funded by The Norwegian Fund for Post-Graduate Training in Physiotherapy.

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This study was funded by The Norwegian Fund for Post-Graduate Training in Physiotherapy