Rate of perceived stability as a measure of balance exercise intensity in people post-stroke

Abstract

Purpose: This study investigates the reproducibility and concurrent validity of the Rate of Perceived Stability (RPS) Scale in people with stroke.

Methods: On two separate days (2-10 days apart), participants provided their RPS ratings during clinical measures: 1)16 tasks from Community Balance and Mobility Scale (CB&M), 2)6-minute walk test (6MWT), and 3)self-paced gait speed. Intraclass correlations (ICCs) assessed between day test-retest reliability of RPS ratings. Standard error of measurement (SEM) and smallest detectable change (SDC) addressed level of between day agreement. Spearman rank correlations (r_s) quantified relationships between RPS, and general rating of perceived challenge, task-performance scores.

Results: Thirty participants with stroke (50% female) participated. ICC ranged from 0.46 to 0.93 across tasks with 12/19 tasks showing ICCs above 0.75 (good test-retest reliability). SEM was 1-point for each task and SDC ranged from 2 to 4 across tasks. Concurrent validity between RPS and ratings of perceived challenge was good-to-excellent (r_s ranged 0.78-0.94, p < 0.01). Higher RPS (indicative of feeling less stable) was associated with lower balance performance scores on CB&M tasks, negative relationships ranged in strength from fair to good-to-excellent in 10/16 tasks (r_s ranged -0.46 to -0.81, p ≤ 0.01).

Conclusions: RPS shows promise as a measure of balance intensity in people with stroke.IMPLICATIONS FOR REHABILITATIONThe RPS is a reliable and valid measure of balance intensity in ambulatory people with stroke.The RPS scale may be a useful clinical tool to address the gap in practice of measuring balance intensity during rehabilitation of walking balance post-stroke.

Keywords: Stroke; balance task intensity; outcome assessment; self-rating; walking balance.