Responsiveness of the Reaching Performance Scale for Stroke

Sandeep K Subramanian; Gita Margolese; Andrea Turolla; Gustavo Saposnik; Mindy F Levin

doi:10.1016/j.apmr.2023.04.020

Responsiveness of the Reaching Performance Scale for Stroke

Arch Phys Med Rehabil. 2023 Oct;104(10):1588-1595. doi: 10.1016/j.apmr.2023.04.020. Epub 2023 May 12.

Authors

Sandeep K Subramanian¹, Gita Margolese², Andrea Turolla³, Gustavo Saposnik⁴, Mindy F Levin⁵

Affiliations

¹ Departments of Physical Therapy, Physician Assistant Studies and Rehabilitation Medicine, University of Texas Health San Antonio, San Antonio, TX.
² School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada.
³ Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Laboratory of Rehabilitation Technologies, Hospital San Camillo IRCCS, Venice, Italy.
⁴ Stroke Outcomes and Decision Neuroscience Unit, Unity Health Toronto, University of Toronto, Toronto, Canada.
⁵ School of Physical and Occupational Therapy, McGill University, Montreal, Canada; Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada. Electronic address: Mindy.levin@mcgill.ca.

PMID: 37178950
DOI: 10.1016/j.apmr.2023.04.020

Abstract

Objective: The objective of the study was to estimate the internal and external responsiveness of the Reaching Performance Scale for Stroke (RPSS) in individuals with stroke.

Design: Retrospective analysis of data from 4 randomized controlled trials.

Setting: Recruitment locations spanning rehabilitation centers and hospitals in Canada, Italy, Argentina, Peru, and Thailand.

Participants: Data from 567 participants (acute to chronic stroke; N=567) were available.

Interventions: All 4 studies involved training using virtual reality for upper limb rehabilitation.

Main outcome measures: RPSS and upper extremity Fugl-Meyer Assessment (FMA-UE) scores. Responsiveness was quantified for all data and across different stages of stroke. Internal responsiveness of the RPSS was quantified as effect-sizes calculated using post and preintervention change data. External responsiveness was quantified using orthogonal regressions between FMA-UE and RPSS scores. The area under the Receiver Operating Characteristic curve (AUC) was quantified based on the ability of RPSS scores to detect change above FMA-UE minimal clinically important different values across different stages of stroke.

Results: The RPSS had high internal responsiveness overall and across the acute or subacute and chronic stages of stroke. For external responsiveness, orthogonal regression analyses indicated that change in FMA-UE scores had positive moderate correlations with both RPSS Close and Far Target scores for all data and across the acute or subacute and chronic stages of stroke (0.6<r<0.7). The AUC was acceptable for both targets (0.65<AUC values<0.8) across the acute or subacute and chronic stages.

Conclusions: In addition to being reliable and valid, the RPSS is also responsive. Along with the FMA-UE, using RPSS scores can help present a more comprehensive picture of motor compensations to characterize poststroke upper limb motor improvement.

Keywords: Movement quality; cerebrovascular accident; compensation; outcomes; reaching; restitution or true recovery; upper limb.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Disability Evaluation
Humans
Randomized Controlled Trials as Topic
Recovery of Function
Retrospective Studies
Stroke Rehabilitation*
Stroke*
Upper Extremity