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Query: UMLS:C0038454 (stroke)
 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this investigation was to determine in 17 stroke patients the correlation between two independent variables (knee extensor muscle torque [KET] and spasticity on the paretic side) and one dependent variable (gait speed). The patients had a mean age of 59 years; time since onset of first stroke was 51 days. Each variable was measured twice on each of two consecutive days. Both KET and spasticity were measured on a Cybex II dynamometer. Peak torque was measured during five-second maximal voluntary isometric knee extension efforts. Spasticity was defined by the relative angle of reversal (RAR) of the Cybex electrogoniometer curve obtained during pendulum tests. Gait speed was measured as patients walked 8.0 meters at their most comfortable speed while using their usual devices. The average of each day's KETs, RARs, and gait speeds was used in the calculation of Pearson product moment correlations. The correlations between KET and gait speed were significant (p less than .05) and were .574 (day 1) and .571 (day 2). The correlations between the RAR and gait speed were not significant (-.204 day 1 and -.262 day 2). All measurements had intraday and/or interday reliability coefficients (ICC 3,1) exceeding .930. The results of this study confirm that gait performance is correlated with measures of KET but not spasticity in stroke patients. Thus, at the knee, extensor muscle torque, unlike spasticity, appears to be justified as a practical and objective clinical measure.
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PMID:Correlation of knee extensor muscle torque and spasticity with gait speed in patients with stroke. 232 87

The purposes of this investigation of patients with stroke were to 1) determine and compare shoulder lateral rotation range of motion (SLRROM) measured at the threshold of pain on the paretic and nonparetic sides; 2) establish the intrarater and interrater reliability of the measurements; and 3) determine the relationship between SLRROM measurements and the independent variables of age, sex, and time since onset of stroke. Subjects were 25 rehabilitation inpatients. The two investigators each measured the patients' SLRROM twice on both the paretic and nonparetic sides using a gravity goniometer. An analysis of variance (ANOVA) demonstrated that SLRROM was significantly less on the paretic side than on the nonparetic side (F = 28.98, p less than .001). The ANOVA demonstrated no difference in the two raters' measurements of SLRROM. The intraclass correlation coefficients (ICC[3,1]) and interrater reliability coefficients were all good to high (.874-.989). The SLRROM on the paretic side correlated significantly with time since onset of stroke (r = -.538, p less than .01). As a consequence of this study, we concluded that 1) patients with stroke tend to lose SLRROM on the paretic side, 2) SLRROM tends to decrease with time, and 3) measurements of SLRROM obtained with a gravity goniometer are reliable and sensitive.
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PMID:Decreased shoulder range of motion on paretic side after stroke. 277 40

The objective of this study was to assess the reliability of the Balance Scale. Subjects were chosen from a larger group of 113 elderly residents and 70 stroke patients participating in a psychometric study. Elderly residents were examined at baseline, and at 3, 6 and 9 months, and the stroke patients were evaluated at 2, 4, 6 and 12 weeks post onset. The Cronbach's alphas at each evaluation were greater than 0.83 and 0.97 for the elderly residents and stroke patients respectively, showing strong internal consistency. To assess inter-rater reliability, therapists treating 35 stroke patients were asked to administer the Balance Scale within 24 hours of the independent evaluator. Similarly, caregivers at the Residence were asked to test the elderly residents within one week of the independent evaluator. To assess intra-rater reliability, 18 residents and 6 stroke patients were assessed one week apart by the same rater. The agreement between raters was excellent (ICC = 0.98) as was the consistency within the same rater at two points in time (ICC = 0.97). The results support the use of the Balance Scale in these groups.
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PMID:The Balance Scale: reliability assessment with elderly residents and patients with an acute stroke. 779 47

Studies on stroke subjects that aim to improve their well-being or community support have not been shown to be effective when measures of disability and handicap have been employed. This paper illustrates the usefulness of the Subjective Index of Physical and Social Outcome (SIPSO) with young adults following a stroke. The study comprised a cross-sectional survey of people (57% male; 39% female; median age 55.7) with a stroke (1-10 years ago), aged 18-65, recruited via NHS stroke registers and young stroke groups (response rate 53%). The SIPSO was incorporated into a postal needs-assessment questionnaire. Median SIPSO score: 24.5 (IQR 17-32). The SIPSO internal reliability: ICC 0.91 (95% CI, 0.90-0.92), item to total SIPSO correlations ranged from 0.52-0.83. The SIPSO construct validity was good: those with poorer employment, mobility and sex-life outcomes had lower SIPSO scores than those with better outcomes; there was no association between age and SIPSO scores, SIPSO scores were not significantly different for men and women. Test-retest reliability was good. The SIPSO had excellent reliability and validity properties in his population. Further work on its responsiveness needs to be carried out. The measurement of personal experience of integration can be a vital basis for effective clinical care.
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PMID:The Subjective Index of Physical and Social Outcome: its usefulness in a younger stroke population. 1509 71

This investigation addressed the question whether non-medical personnel could produce similar ratings to physicians when applying ADL scales. A sports scientist was trained in the assessment of stroke patients with the Barthel Index, the Activity Index and the Nottingham Extended Activities of Daily Living Scale. He and a rehabilitation physician assessed 20 stroke patients in first in-patient rehabilitation with these instruments. Measurements of inter-rater reliability were calculated for scores, subscales and single items, and for the latter also rater correspondence. Inter-rater reliability was good to excellent for all scores and subscales (ICC: 0.82-0.99). Reliability and correspondence was good to excellent for the items of the Barthel Scale, satisfactory to excellent for those of the Activity Index. Some 25 % of the items of the Nottingham Extended Activities of Daily Living revealed unsatisfactory reliability but still high inter-rater correspondence. Results indicate that physicians and non-medical personnel are able to apply these scales reliably to stroke patients.
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PMID:[Inter-rater reliability of the Barthel Index, the Activity Index, and the Nottingham Extended Activities of Daily Living: The use of ADL instruments in stroke rehabilitation by medical and non medical personnel]. 1510 Sep 16

We established reliability of upper-limb muscle performance in adults with post-stroke hemiparesis. Ten adults with post-stroke hemiparesis (51.5 +/- 34.5 months) performed isokinetic concentric shoulder flexion, elbow flexion, and extension at 3 criterion speeds (30 degrees/s, 75 degrees/s, and 120 degrees/s) on 3 separate occasions (Days 1, 7, and 49). As several participants were unable to reach criterion speeds, actual speed and power were also analyzed. Relative reliability (intraclass correlation coefficient-ICC) was excellent for torque and power (0.82 to 0.98) but less consistent for speed (0.63 to 0.99). Absolute reliability (standard error of measurement-%SEM) ranged between 0% to 34%. No systematic errors were observed across sessions. Smallest real differences (SRD) ranged between 4-11Nm for torque and 3-24W for power. Shoulder flexion, elbow flexion, and elbow extension torque, speed, and power can be measured reliably following stroke. Given that many of these individuals demonstrate inability to generate torque at preselected speeds, power may be a more valid indicator of muscle performance.
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PMID:Reliability of dynamic muscle performance in the hemiparetic upper limb. 1638 56

We aimed to determine the repeatability and variation of quantitative gait data in patients with stroke and to compare the subgroups in terms of gait variability. Time-distance and kinematic characteristics of gait were evaluated in 90 inpatients (30 women) with hemiparesis (mean+/-S.D. age 57.7+/-12.5 years and time since stroke 5.99+/-6.46 months). Subgroups were based on "gender", "side of paresis", "lesion type", "motor recovery level", "sensory status", "time since stroke" and "walking velocity". Repeatability was adequate to excellent in all stroke subgroups (ICC range 0.48-0.98). Walking velocity was the most repeatable gait parameter after stroke. Variation in step length was significantly higher in women than in men (CV 16% versus 9%, p<0.05). Slow walkers (walking velocity <0.34 m/s) had a higher variation than fast walkers in step length (CV 12.5% versus 7.5%, p<0.01), single support time (CV 11.9% versus 6.3%, p<0.05), peak hip extensions in stance (CV 11.5% versus 3.7%, p<0.01) and knee flexion in swing (CV 11.8% versus 6.5%, p<0.05). In our stroke patients, their age, time since injury, lesion characteristics, impaired proprioception or level of motor recovery had no effect on gait variability. For better interpretation of quantitative gait data, clinicians should consider that variation in step length, single support time, peak hip extension in stance and knee flexion in swing differs according to walking velocity after stroke.
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PMID:Repeatability and variation of quantitative gait data in subgroups of patients with stroke. 1768 65

Stroke can affect the physical, emotional, and social aspects of patients' lives. The purpose of this study was to assess the feasibility and psychometric properties of a telephone-administered version of the Health Utilities Index Mark 2 and 3 (HUI2/3). Subjects included patients who had had an ischemic stroke within the prior 12 months and their unpaid caregivers (n = 76 pairs) and an additional 33 unpaid caregivers of patients who were generally aphasic or severely affected. Complete response rates, test-retest reliability, and convergent, divergent, and known-groups validity were determined. For patient-caregiver pairs, 27% had no complete Health Utilities Index Mark 2 (HUI2) responses (i.e., had missing responses for at least 1 item of each assessment), 51% had partial responses (i.e., had complete responses for at least 1, but not all of the assessments), and 22% had complete responses. For the Health Utilities Mark 3 (HUI3), the percentages were 19%, 52%, and 29%. Test-retest reliability for patients intraclass correlation coefficient (ICC = 0.76 for HUI2; 0.75 for HUI3) and caregivers (ICC = 0.91 and 0.89, respectively) were excellent. There were generally high levels of both convergent and divergent validity. There was limited known-groups validity (mild v moderately and mild v severely affected patients reported different overall HUI2 and HUI3 scores; there was no difference between those with moderate and severe disabilities). The same pattern was found for caregivers. We conclude that the telephone-administered HUI2/3 appears to be reliable and have at least limited validity. However, the proportions of missing data for patient/caregivers administered the HUI2/3 were surprisingly high. This high proportion of missing data would limit the use of the telephone-administered HUI2/3 in the context of stroke trials.
J Stroke Cerebrovasc Dis
PMID:Telephone assessment of functioning and well-being following stroke: is it feasible? 1790 61

The WHODAS II (World Health Organization Disability Assessment Schedule II) is a questionnaire derived from the ICF classification system (International Classification of Functioning, Disability and Health) for the evaluation of disabilities and handicaps. Data on its validity and reliability with respect to the consequences of stroke are largely lacking. The present study aimed at measurements of reliability of the WHODAS II in its application to stroke patients and their closest others. Eighty-four patient-relative pairs were assessed six months after stroke with the self- and observer-rating versions. From the patients' and relatives' judgements, Cronbach's alpha was computed as measurement of internal consistency, intra-class correlation coefficients as measurements of the inter-rater reliability of subscales and total scores, and Spearman's rho (rho) for the inter-rater reliability for single items. In addition, the inter-rater correspondence was calculated as the percentage of responses. The internal consistency was found to be good to excellent (alpha=0.81-0.99) both for patients' and relatives' judgements. Inter-rater reliabilities ranged from satisfactory for the subscale Understanding and Communication to excellent for the total score (ICC 0.64-0.94). However, the inter-rater reliability of the items as well as their percental correspondence was hardly satisfactory, with few exceptions in the realms of Life Activities and Self-Care (rho=0.24-0.90 and percental correspondence 29.6%-75.7%). Our results demonstrate that the WHODAS II is a reliable instrument for the assessment of stroke patients, both as a self- and an observer-rating questionnaire. Whereas the correspondence between patient and relative may be disparate with respect to single items - especially those not directly observable -, subscale and total scores seem to allow predictions based on observer judgements. The assessment of stroke patients' disabilities and handicaps through relatives' judgements with the WHODAS II scales is reliable.
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PMID:[Use of the WHODAS II with stroke patients and their relatives: reliability and inter-rater-reliability]. 1824 69

A prefabricated oral screen has shown promising results as a muscle self-training device to improve the lip function of stroke patients affected by oropharyngeal dysphagia. However, a technique for the measurement of lip muscle force, whether in healthy individuals or in stroke patients, is lacking. The present study was designed to (1) test the intra- and interreliability of lip force measurements by means of a newly devised Lip Force Meter, LF100, (2) determine a normal lower limit for lip force in newtons (N), and (3) ascertain the instrument's sensitivity and specificity. LF100 is a modified strain gauge for recording the ability of lips to withstand pressure from a predentally placed oral screen. Forty-two healthy controls and 22 stroke patients agreed to participate in the trial. The controls and patients were examined three times with the LF100, with 2-min rest intervals, twice by investigator MH and once by investigator MO. Intrainvestigator reliability with the LF100 proved excellent in both controls and patients: ICC was 0.83 and 0.90, respectively. Interinvestigator reliability was good or excellent in both groups: ICC was 0.71 and 0.91. There was a significant difference in lip force between controls and stroke patients (mean = 24.7 +/- 6.3 N and 9.5 +/- 5.5 N, p < 0.001). The sensitivity of LF100 was 91% and the specificity 95%. The cutoff level for normal lip force was 15 N. The LF100 showed itself to be a suitable and reliable instrument for measuring lip force.
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PMID:Reliable lip force measurement in healthy controls and in patients with stroke: a methodologic study. 1825 90


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