Assessing Leg Control in People With Chronic Stroke
Condition: Chronic Stroke
MeSH terms: Stroke
Study type: Observational

Summary: 
      The purpose of this study is to compare the clinometric (psychometric) properties of the
      SCALE and FMA-LE assessments in adults after stroke. A second purpose is to determine how
      well each measure predicts walking speed using the 10 meter walk test.
    

Detailed description: 
      Selective voluntary motor control may be important in prognosticating future function in
      adults post stroke. It is therefore important to measure selective voluntary motor control
      using assessments that are valid, reliable and easy to perform and interpret. Current
      assessments are time consuming and complicated. Clinicians who work with patients post stroke
      will benefit from this research because they will have evidence supporting appropriate
      measurement of selective voluntary motor control. This evidence may inform their clinical
      decision making when working with patients. Patients who have survived a stroke will benefit
      because their therapists will be able to better measure their selective voluntary motor
      control which may one day lead to better prediction of functional outcomes and the selection
      of appropriate interventions.

      The Fugl-Meyer assessment (FMA) is the "Gold Standard" for the assessment of individuals with
      brain injury, most commonly those surviving cerebrovascular accident (stroke). The full
      assessment is complicated and can take more than an hour to complete. Clinicians have limited
      time to perform a full evaluation of their patients, the FMA is just one part of this
      evaluation. The lower extremity selective voluntary motor control component of the FMA
      (FMA-LE) is difficult for clinicians who are not experts to perform and interpret. For these
      reasons, few practicing clinicians use the FMA. However, measuring selective voluntary motor
      control may be important for prognosticating patients' future functional level and their need
      for continued therapeutic interventions. The Selective Control Assessment of Lower Extremity
      (SCALE) was developed for use with children who have cerebral palsy (CP), a condition that in
      some ways presents similar to stroke. The SCALE has been validated and deemed reliable in the
      pediatric population with CP. This study aims to determine inter-rater and intra-rater
      reliability for the FMA-LE and the SCALE. In addition, scores on the SCALE will be compared
      to scores on the FMA-LE to determine concurrent validity. Finally the scores on the SCALE and
      FMA-LE will be compared to the time it takes for stroke survivors to walk 10-meters (10-meter
      walk test) to determine how well each measure predicts functional status (predictive
      validity).
    

Intervention name(s): Selective Control Assessment of Lower Extremity (SCALE)
Intervention type(s): Behavioral
Intervention description(s): Inter- and intra-rater reliability Validity: correlation analysis with Fugl-Meyer Assessment - Lower Extremity Component (FMA-LE) and 10 meter walk test (see below)
Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Adults with chronic stroke
      
Keywords: stroke; selective voluntary motor control