Cevher DEMİRCİ, Saniye AYDOĞAN ARSLAN, Hatice YAKUT, Meral SERTEL, Süleyman KUTLUHAN

Kronik İnmede İnmeli Hastalar için Postüral Değerlendirme Ölçeği'nin Psikometrik Özelliklerinin Berg Denge Ölçeği ve Brunel Denge Değerlendirmesi ile Karşılaştırılması

Amaç: Bu çalışmanın amacı, İnmeli Hastalar için Postüral Değerlendirme Ölçeği’ nin (PASS) Türkçe versiyonunun kronik inmede geçerliğini doğrulamak, geçerlik, güvenirlik ve cevap verme özelliklerini Berg Denge Ölçeği (BDÖ) ve Brunel Denge Değerlendirmesi (BDD) ile karşılaştırmaktır.Yöntem: Çalışmaya 49 kronik inme hastası dahil edildi. Çalışmaya katılanlara ilk gün PASS, BDÖ ve BDD uygulandı. Test-tekrar test güvenirliğini ölçmek için, ilk değerlendirmeden 1 hafta sonra aynı fizyoterapist tarafından ikinci değerlendirme yapıldı.Bulgular: Korelasyon analizine göre PASS birinci ve ikinci değerlendirme skorları arasında çok yüksek düzeyde bir ilişki tespit edildi (r = 0.984). Cronbach Alpha Katsayısı 0.995 (mükemmel) olarak bulundu. PASS için sınıf içi korelasyon katsayısı (ICC) değeri 0.995 idi. PASS, BDÖ ve BDD arasında yüksek düzeyde ilişki tespit edildi. PASS için tavan ve taban etkisi gözlenmedi.Sonuç: Çalışmamızın sonuçları, kronik inmeli hastalarda PASS Türkçe versiyonunun geçerli ve güvenilir olduğunu ve dengeyi değerlendirmek için yaygın olarak kullanılan bu üç ölçeğin de kronik inmeli hastalarda tekrarlanabilir ölçümler yaptığını göstermiştir. Bu üç ölçeğin test tekrar test güvenirlik değerleri mükemmel bulunmuştur. Klinisyenler tarafından inme hastalarında gerçek denge değişikliğini belirlemek için kullanılan tespit edilebilir minimal değişim değerleri, bu denge ölçekleri için birbirine yakın bulunmuştur.

Anahtar Kelimeler:

Denge, Mobilite, Geçerlik, Güvenirlik

Comparison of Psychometric Properties of the Postural Assessment Scale for Stroke Patients with Berg Balance Scale and Brunel Balance Assessment for Chronic Stroke

Objective: The purpose of the present study was to verify the validity of the Turkish version of the Postural Assessment Scale for Stroke Patients (PASS) in chronic stroke, and to compare its validity, reliability, and responsiveness characteristics with Berg Balance Scale (BBS), Brunel Balance Assessment (BBA).Method: 49 chronic stroke patients were included in the study. Those participating in the study were applied PASS, BBS and BBA on the first day. To measure the test-retest reliability, the second assessment for the scales was performed by the same physiotherapist 1 week after the initial evaluation.Results: According to the correlation analysis, a very high level of correlation was found between the PASS first and second assessment scores (r = 0.984). Cronbach Alpha Coefficient was found to be 0.995 (excellent). The Intraclass Correlation Coefficient (ICC) value for PASS was 0.995. A high level of correlation was found between PASS, BBS and BBA. No ceiling and floor effects were observed for PASS.Conclusion: The results of our study showed that Turkish version of PASS is a valid and reliable scale in chronic stroke patients and all these three scales, which are commonly used to assess balance in stroke patients are, made repeatable measurements in patients with chronic stroke. The test re-test reliability values of these three scales were found to be excellent. Minimal detectable change values, which are used to determine a real change in balance in stroke patients by clinicians, were found to be close to each other for these balance scales.

Keywords:

Balance, Mobility, Validity, Reliability,

PDF

___

1. Iqbal, K. (2011). Mechanisms and models of postural stability and control. Annual International Conference of the IEEE Engineering in Medicine and Biology Society.Engineering in Medicine and Biology Society. IEEE Annual International Conference, 2011, 7837-7840.
2. de Oliveira, C. B., de Medeiros, I. R., Frota, N. A., Greters, M. E. & Conforto, A. B. (2008). Balance control in hemiparetic stroke patients: main tools for evaluation. J Rehabil Res Dev, 45(8), 1215–1226.
3. Geurts, A. C., de Haart, M., van Nes, I. J., Duysens, J. (2005). A review of standing balance recovery from stroke. Gait & posture, 22(3), 267-281.
4. Goljar, N., Rudolf, M., Bizovicar, N. (2019). Algorithm for selection of balance assessment tools in post-stroke patients. Int J Rehabil Res, 42(3), 229-233.
5. Beaton, D., Bombardier, C., Katz, J., Wright, J. (2001). A taxonomy for responsiveness. J Clin Epidemiol, 54(12), 1204-1217.
6. Benaim, C., Pérennou, D. A., Villy, J., Rousseaux, M., Pelissier, J. Y. (1999). Validation of a standardized assessment of postural control in stroke patients: the Postural Assessment Scale for Stroke Patients (PASS). Stroke, 30(9), 1862-1868.
7. Koçak, F. A., Kurt, E. E,, Koçak, Y., Erdem, H. R., Tuncay, F., Benaim, C. (2019). Validity and interrater/intrarater reliability of the Turkish version of the postural assessment scale for stroke patients (PASS-Turk). Top Stroke Rehabil, 26(5), 373-381.
8. Sahin, F., Buyukavci, R., Sag, S., Dogu, B., Kuran, B. (2013). Reliability and validity of the Turkish version of the Berg Balance Scale in patients with stroke. Turk J Phys Med Rehabil, 59(3), 170-176.
9. Tyson, S. F, De Souza, L. H. (2004).Development of the Brunel Balance Assessment: a new measure of balance disability post stroke. Clin Rehabil, 18(7), 801-810.
10. Aydoğan Arslan, S., Yakut, H., Demirci, C. S., Sertel, M., Kutluhan, S. (2020). The reliability and validity of the Turkish version of Brunel Balance Assessment (BBA-T). Top Stroke Rehabil, 27(1), 44-48.
11. Koo, T. K., Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. J Chiropr Med, 15(2), 155–163.
12. Akoglu, H. (2018). User's guide to correlation coefficients. Turk J Emerg Med, 18(3), 91-93.
13. Altman, D. G. (1990). Practical statistics for medical research. CRC press.
14. Lesser, M., Borst, J., Dekerlegand, J. (2017). Use of the postural assessment scale for stroke patients in determining acute care discharge recommendations. J Acute Care Phys Ther, 8(3), 79-85.
15. Huang, Y. C., Wang, W. T., Liou, T. H., Liao, C. D., Lin, L. F., Huang, S. W. (2016). Postural assessment scale for stroke patients scores as a predictor of stroke patient ambulation at discharge from the
rehabilitation ward. J Rehabil Med, 48(3), 259-264.
16. An, S. H., Lee, J. H. (2009). Reliability and validity of the postural assessment scale for stroke in chronic stroke patients. J Kor Phys Ther, 21(1), 9-17.
17. Mao, H. F., Hsueh, I. P., Tang, P. F., Sheu, C. F., Hsieh, C. L. (2002). Analysis and comparison of the psychometric properties of three balance measures for stroke patients. Stroke, 33(4), 1022-1027.
18. Bergqvist, G. M., Nasic, S., Persson, C. U. (2019). Inter-rater reliability of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) in the acute phase after stroke.
Top Stroke Rehabil, 26(5), 366-372.
19. Blum, L., Korner-Bitensky, N. (2008). Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review. Phys Ther, 88(5), 559-566.
20. Liaw, L. J., Hsieh C. L., Lo, S. K., Chen, H. M., Lee, S., Lin, J. H. (2008). The relative and absolute reliability of two balance performance measures in chronic stroke patients. Disabil Rehabil, 30(9), 656- 661.
21. Saso, A., Moe-Nilssen, R., Gunnes, M., Askim, T. (2016). Responsiveness of the Berg Balance Scale in patients early after stroke. Physiother Theory Pract, 32(4), 251-261.
22. Alghadir, A. H., Al-Eisa, E. S., Anwer, S., Sarkar, B. (2018). Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke. BMC Neurol, 18(1), 141.
23. Cheng, J., Dong, L., Liu, Y., Jing, L., Liu, Y., Wang, Y, et al. (2017). Correlation between reliability and validity of Brunel balance assessment with activities of daily living. Chongqing Medicine, 46(17), 2353-2355,
24. Tyson, S. F., Hanley, M., Chillala, J., Selley, A. B., Tallis, R. C. (2007). The relationship between balance, disability, and recovery after stroke: predictive validity of the Brunel Balance Assessment. Neurorehabil Neural Repair, 21(4), 341-346.
25. Xiao, L., Luo, Z., Liao, L. (2009). Validity and reactivity of the Chinese version of Brunel balance assessment in stroke hemiplegic patients. Chinese J. Rehabilitation Med., (1):13.
26. Wang, C., Sheu, C. F., Protas, E. (2009). Test-retest reliability and measurement errors of six mobility tests in the community-dwelling elderly. Asian J Gerontol Geriatr, 4(1), 8-13.