Correlations between subjective rating and objective assessment of balance function in individuals with stroke

Abstract

Purpose

To examine the relationships among therapist-reported, patient-reported, and objective assessment scores of balance function.

Methods

Inpatients with stroke and occupational therapists were recruited. The objective balance scores were measured using the Balance Computerized Adaptive Testing (Balance CAT) system. The therapist and patient-reported scores were evaluated using a visual analogue scale (VAS) and Likert-type scale.

Results

Eighty-eight patients and 16 therapists participated. The correlations (r= 0.64 and 0.65; R-squared about 0.42 at baseline and follow-up assessments, respectively) between the therapist-reported VAS scores and the Balance CAT system were larger than those (r = 0.31 and 0.21) between the patient-reported VAS scores and the Balance CAT system. Low correlations (r = 0.27 and 0.26 for VAS and Likert-type scores, respectively) were found between the therapist-reported and patient-reported change scores. Low correlations (r = 0.12–0.17) were found between the change scores of therapist- and patient-reported ratings and those of the Balance CAT system.

Conclusions

The therapists’ judgments explained <50% of variance of the Balance CAT system scores. Neither therapist-reported nor patient-reported change scores reflected the changes demonstrated by the objective assessments. Further studies are warranted to confirm our findings.

Implications for Rehabilitation

• Neither therapist- nor patient-reported balance function and change could effectively reflect the scores resulting from objective assessments.

• The routine use of objective balance assessments should not be replaced by therapists’ subjective judgments.

• Communications regarding the balance function measured by objective assessments between therapists and patients can help patients to better understand their balance function and progress.

Keywords:

• Balance
• stroke
• subjective rating
• objective assessment
• rehabilitation

Disclosure statement

The authors report no conflicts of interest.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

This study was supported by grants from the Chung Shan Medical University and Chi Mei Medical Center [CSMU-CMMC-102-06 and CMCSMU10205].