Intra- and inter-rater reliability of the Stroke Rehabilitation Assessment of Movement (STREAM)
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Abstract
Objectives: To examine intra-rater and inter-rater reliability of the STREAM Thai version in evaluating motor recovery of patients with stroke.
Materials and methods: Thirty patients with stroke (mean age 62.5±13.5 yrs.) participated in the study. Time post stroke was between 15 days to 5 years. Seventeen participants had left hemiparesis and 13 participants had right hemiparesis. Raters were physical therapists experienced in stroke rehabilitation and received STREAM training. For intra-rater reliability test, the same physical therapist re-assessed each patient through videotape 7 days after the first assessment. For inter-rater reliability test, STREAM Thai version was administered to each patient by two physical therapists in a random order and the same setting within 24 hours interval. Intra-rater and inter-rater reliability was calculated using intraclass correlation coefficients (ICC) model 3, 1 and 2, 1, respectively. The significance level was set at p<0.05.
Results: Intra-rater reliability of the STREAM Thai version and all subcomponents was demonstrated by ICC of 0.99. ICC for inter-rater reliability was 0.96. Sub-analysis for each component revealed the ICCs of 0.98, 0.94 and 0.83 for estimating the inter-rater reliability of upper limb movement, lower limb movement, and basic mobility, respectively. Bland Altman plots revealed that mean difference between assessments was -1.4 points (95% confidence interval between -7.2 and 4.3 points), between raters was -5.5 points (95% confidence interval between -23.8 and 12.8 points).
Conclusion: Assessment of motor recovery in patients with stroke using STREAM Thai version by trained PT who had stroke rehabilitation experience was highly reliable for both intra-rater and inter-rater.
Journal of Associated Medical Sciences 2017; 50(1): 71-86. Doi: 10.14456/jams.2017.7
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Personal views expressed by the contributors in their articles are not necessarily those of the Journal of Associated Medical Sciences, Faculty of Associated Medical Sciences, Chiang Mai University.
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