Intra rater reliability and validity of simplified stroke rehabilitation assessment of movement (s-stream) scale on voluntary movement of the limbs and basic mobility in patients with stroke – An observational study

Authors : Michael Selvaraj.A, R M Singaravelan

DOI : 10.18231/j.ijn.2019.026

Volume : 5

Issue : 3

Year : 2019

Page No : 167-171

Introduction: A stroke is a clinical syndrome characterised by rapidly developing clinical symptoms and /
or signs of focal, and at times global, loss of cerebral function, with symptoms lasting more than 24 hours
or leading to death, with no apparent cause other than that of vascular origin. Globally, cerebrovascular
disease (stroke) is a second leading cause of death. For providing a better management we must evaluate
the patient with a good valid and reliable tool. In physiotherapy for evaluating the stroke subjects mobility
and functional activity there are many assessment tools are available for assessing Balance, Functional
activity, mobility and gait through Berg Balance Scale, Functional Independence Measure, Barthal Index
and observational Gait Analysis. Other than these scales, Stroke Rehabilitation Assessment of Movement
Scale (STREAM) is one of the good reliable and valuable scale for the assessing of mobility and functional
activity in stroke patients .
Aim of the Study: The aim of this study was to evaluate the Intra rater reliability and validity of Simplified-
STREAM (S-STREAM) Scale on mobility and functional activity in patients with Stroke.
Materials and Methods: This study was carried out for the period of one year. 100 stroke patients were
selected from Neurology ward of Sri Ramakrishna Hospital, Coimbatore who fulfilled the inclusion criteria.
Intra rater reliability of S-STREAM was assessed for 1st and 2nd day of consequent 3 weeks. Validity of
S-STREAM scale was evaluated by comparing the components of S-STREAM scale’s upper and lower
limb voluntary movement with Fugl-meyer motor assessment scale components; Mobility component of
S-STREAM was compared with Rivermead mobility index scale on first day of assessment.
Data analysis of Intra-rater reliability and validity done with an help of Pearson’s correlation coefficient
test.
Conclusion: The results of this study shows that the S-STREAM has high Intra rater reliability and validity
when compare with the Fugl-meyer and Rivermead mobility index on functional activity and mobility in
patients with stroke. Further the S- STREAM scale was efficient to administer, as it consists of only half
the number of items in the original STREAM. Therefore the study recommends S-STREAM is a reliable
and valid tool for measuring mobility and functional activity in stroke patients.
Results: The result of this analyses shows that S-STREAM scale has high intra-rater reliability and validity
when comparing with Fugl-meyer motor assessment and Rivermead mobility index on voluntary movement
of the limbs and basic mobility in patients with stroke.

Keywords: Simplified Stroke Rehabilitation, Assessment of Movement, Fugl-meyer motor assessment, Rivermead mobility index, Intra –rater reliability, Validity


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