Test-Retest Reliability of the ABILOCO Questionnaire in Individuals with Stroke.

BACKGROUND: The ABILOCO is a self-reported questionnaire, specific for individuals with stroke, for the assessment of ability of locomotion. The ABILOCO has been investigated using the Rasch model and has shown satisfactory measurement properties. However, its test-retest reliability has not been investigated. OBJECTIVE: To investigate the test-retest reliability, that is, agreement, systematic and random variability of the ABILOCO Questionnaire in individuals with chronic stroke. DESIGN: A test-retest reliability study. SETTING: Research laboratory. PARTICIPANTS: Thirty-one individuals (21 men and 10 women; mean age, 60 years), who had poststroke hemiparesis. INTERVENTION: Not applicable. MAIN OUTCOME MEASUREMENT: The ABILOCO was applied twice, on two occasions, 5 to 7 days apart. Test-retest reliability was investigated, as follows: agreement by the calculation of intraclass correlation coefficients (ICCs); systematic variability by the change in the mean; random variability by the standard error of measurement (SEM) and smallest real difference (SRD). RESULTS: Two outliers were identified in the sample. The ICC values for the whole sample were 0.76 (CI 95% 0.56 to 0.88), whereas the SEM (SEM%) and SRD (SRD%) were 0.55 (21%) and 1.52 (58%), respectively. CONCLUSION: The ABILOCO showed to be reliable to be applied within clinical and research contexts for the assessment of changes in locomotion ability of a group of individuals with chronic stroke. However, it appears to be less suitable to detect changes at individual levels. LEVEL OF EVIDENCE: III.

Performance and capacity-based measures of locomotion, compared to impairment-based measures, best predicted participation in individuals with hemiparesis due to stroke.

PURPOSE: To determine the potential predictors of participation of individuals with post-stroke hemiparesis, taking into account modifiable variables of impairments, activity limitations, and environmental factors. METHODS: One hundred and nine individuals (58 ± 12 years; 64 men) participated in this study. Outcomes included measures of impairments (depressive symptoms: Geriatric Depression Scale and motor-based impairments: finger-to-nose test, lower extremity (LE) motor coordination test, and handgrip strength, isometric strength of the LE muscles), activity (capacity: 10-meter walking speed test and Test d'Évaluation des Membres Supérieurs de Personnes Agées; performance: locomotion and manual abilities; environmental factors (Measure of the Quality of the Environment); and participation: Assessment of Life Habits (LIFE-H 3.1 Brazil)). RESULTS: Regression analyses revealed that the explanatory variables accounted for 59% and 49% of the variance in the LIFE-H 3.1 Brazil daily activity and social role sub-scales, respectively. Locomotion performance (R2 = 39%; p < 0.0001) and walking speed (R2 = 32%; p < 0.0001) were the best predictors of the LIFE-H 3.1 Brazil daily activity and social role sub-scales, respectively. Depressive symptoms were the only impairments, which were retained in both models. CONCLUSIONS: Performance and capacity-based measures of locomotion showed to be the best predictors of participation. Additionally, depressive symptoms should not be underlooked. Implications for Rehabilitation Activity-related measures of locomotion showed to be the main predictors of participation in individuals with post-stroke hemiparesis, as assessed by the daily activity and social role sub-scales of the LIFE-H 3.1. The daily activity model was best predicted by measures of performance, whereas the social role sub-scale, by measures of capacity. Although small, the impact of depressive symptoms on participation should not be underlooked. Locomotion appeared to be essential for participation and increases in walking speed and locomotion ability should be the main goals for both professionals and individuals, when the aim is to increase participation.

Strength deficits of the paretic lower extremity muscles were the impairment variables that best explained restrictions in participation after stroke.

PURPOSE: To evaluate which measures of physical impairments of both upper extremity (UE) and lower extremity (LE) would predict restrictions in participation with 105 community-dwelling stroke subjects. METHODS: For this cross-sectional, exploratory study, participation was assessed by the daily activity and social role domains of the Assessment of Life Habits (LIFE-H). The potential predictors included measures of physical impairments (UE and LE motor recovery, sensation, motor coordination, and strength deficits). RESULTS: Step-wise multiple linear regression analyses revealed that, for the daily activity domain, LE strength deficits and UE motor recovery explained 28% of the variance in the LIFE-H scores and LE strength deficits alone explained 22% (F = 29.5; p< .0001). For the social role domain, LE strength deficits and sensation explained 22% of the variance in the LIFE-H scores and LE strength deficits alone explained 16% (F = 20.6; p< .0001). CONCLUSIONS: Strength deficits of the LE muscles were the physical impairment variables that best predicted participation in both daily activity and social role domains of the LIFE-H. Although significant, UE motor recovery and LE sensation added little to the explained variance. Future research is needed to determine whether progressive resistance strength training program enhances participation after stroke. Implications for Rehabilitation Residual strength deficits of the LE muscles were the physical impairments that showed to be the main predictors of restrictions in participation, as determined by the daily activity and social role domains of the LIFE-H 3.1. It is possible that stroke individuals would benefit from physical interventions aiming at improving the strength of the LE muscles, when the goal is to enhance participation.