Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke

ABSTRACT

Background: Before implementation of the new scale, the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS), to clinical practice, it is fundamental to analyze its measurement properties.Objective: To examine the inter-rater reliability of the SwePASS in the acute phase after stroke.

Methods: Day 3 to day 7 after admission to a stroke unit, 64 persons with stroke were assessed twice, using the SwePASS, by two physiotherapists. Inter-rater reliability was determined using percentage-agreement and the rank-invariant method: relative position, relative concentration, and relative rank variance.

Results: The raters showed a percentage agreement of ≥75% in the assessments using the SwePASS. For 9 of the 12 items, the percentage agreement was >80%. For 8 of the 12 items, there was a statistically significant change in position, revealed in relative position values between 0.08 and 0.15. Three items had statistically significant positive relative concentration values between −0.11 and 0.10. Except for a statistically significant negligible relative variance value of 0.01 for the items 1 and 8, there was no relative variance.

Conclusions: The SwePASS shows an acceptable inter-rater reliability, albeit with potential for improvement. The reliability can be improved by a consensus how to interpret the scale between the raters prior to implementation in the clinic.

KEYWORDS:

• Postural balance
• acute stroke
• stroke rehabilitation; reliability of results; reproducibility of results

Acknowledgments

The authors would like to thank the RPTs Cathrin Carlsson and Lisa Åström and other colleagues at the Stroke Unit and the Occupational and Physiotherapy Unit at Skaraborg Hospital Skövde and Åsa Rejnö for advice.

Additional information

Funding

This work was supported by Medical Fund, Skaraborg Hospital Skövde [170101];Skaraborgsinstitutet [160801];Research and Development Centre, Skaraborg Hospital Skövde [151013].