• Top Stroke Rehabil · Jan 2019

    Rasch analysis of the upper-limb subscale of the stroke rehabilitation assessment of movement (STREAM) tool in an acute stroke cohort Rasch analysis of the upper-limb subscale of the STREAM tool in an acute stroke population.

    • Bilal A Mateen, Karen Baker, and E Diane Playford.
    • a Warwick Medical School , University of Warwick , Coventry , UK.
    • Top Stroke Rehabil. 2019 Jan 1; 26 (1): 24-31.

    BackgroundStroke is a leading cause of disability worldwide. The most common impairment resulting from stroke is upper-limb weakness.ObjectivesTo determine the usefulness and psychometric validity of the upper-limb subscale of the STREAM in an acute stroke population.MethodsRasch Analysis, including unidimensionality assumption testing, determining model fit, and analysis of: reliability, residual correlations, and differential item functioning.Results125 individuals were assessed using the upper-limb subscale of the Stroke Rehabilitation Assessment of Movement (STREAM) tool. Rasch analysis suggests the STREAM is a unidimensional measure. However, when scored using the originally proposed method (0-2), or using the response pattern (0-5) neither variant fit the Rasch model (p < 0.05). Although, the reliability was good (Person-Separation Index - 0.847 and 0.903, respectively). Correcting for the disordered thresholds, and thereby producing the new scoring pattern, led to substantial improvement in the overall fit (chi-square probability of fit - 22%), however, the reliability was slightly reduced (PSI - 0.806).ConclusionsThe study proposes a new scoring method for the upper-limb subscale of the STREAM outcome measure in the acute stroke population.

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