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

Abstract

Purpose

This study investigates the reproducibility and concurrent validity of the Rate of Perceived Stability (RPS) Scale in people with stroke.

Methods

On two separate days (2–10 days apart), participants provided their RPS ratings during clinical measures: 1)16 tasks from Community Balance and Mobility Scale (CB&M), 2)6-minute walk test (6MWT), and 3)self-paced gait speed. Intraclass correlations (ICCs) assessed between day test-retest reliability of RPS ratings. Standard error of measurement (SEM) and smallest detectable change (SDC) addressed level of between day agreement. Spearman rank correlations (r_s) quantified relationships between RPS, and general rating of perceived challenge, task-performance scores.

Results

Thirty participants with stroke (50% female) participated. ICC ranged from 0.46 to 0.93 across tasks with 12/19 tasks showing ICCs above 0.75 (good test-retest reliability). SEM was 1-point for each task and SDC ranged from 2 to 4 across tasks. Concurrent validity between RPS and ratings of perceived challenge was good-to-excellent (r_s ranged 0.78–0.94, p < 0.01). Higher RPS (indicative of feeling less stable) was associated with lower balance performance scores on CB&M tasks, negative relationships ranged in strength from fair to good-to-excellent in 10/16 tasks (r_s ranged −0.46 to −0.81, p ≤ 0.01).

Conclusions

RPS shows promise as a measure of balance intensity in people with stroke.

IMPLICATIONS FOR REHABILITATION

• The RPS is a reliable and valid measure of balance intensity in ambulatory people with stroke.

• The RPS scale may be a useful clinical tool to address the gap in practice of measuring balance intensity during rehabilitation of walking balance post-stroke.

Keywords:

• Stroke
• walking balance
• balance task intensity
• self-rating
• outcome assessment

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported in part by grants from the New Frontiers in Research Fund (Exploration grant, CLP) and the Michael Smith Foundation for Health Research (Scholar Award, CLP).