Assessments do nothing unless they are directly followed by EXACT PROTOCOLS THAT DELIVER RECOVERY! Inter-rater reliability is useless because it means you're doing a subjective diagnosis, NOT AN OBJECTIVE DIAGNOSIS! Since you don't understand what you're doing: YOU'RE FIRED!
Inter-rater reliability and validity of the stroke rehabilitation assessment of movement (STREAM) instrument
Chun-Hou Wang,
1
Ching-Lin Hsieh,
2
May-Hui Dai,
3
Chia-Hui Chen
3
and Yu-Fen Lai
3
From the
1
School of Rehabilitation, Chung-Shan Medical and Dental College, Taichung,
2
School of Occupational Therapy,
College of Medicine, National Taiwan University, Taipei, and
3
Department of Physical Therapy, Chung-Shan Medical and
Dental College Hospital, Taichung, Taiwan, ROC
The Stroke Rehabilitation Assessment of Movement
(STREAM) instrument is used to measure motor and
mobility problems in patients who have experienced a
stroke. The purposes of the study were to examine the inter-
rater reliability, concurrent and convergent validity of the
STREAM instrument in stroke patients. Fifty-four stroke
patients participated in the study. For the purpose of inter-
rater reliability, the STREAM instrument was administered
by two raters on each patient within a 2-day period. Validity
was assessed by comparing the patients’ scores on the
STREAM instrument with those obtained from the other
well-established measures. Weighted kappa statistics for
inter-rater agreement on scores for individual items ranged
from 0.55 to 0.94. The intraclass correlation coefficient for
the total score was 0.96 indicating very high inter-rater
reliability. The intraclass correlation coefficients were also
very high in each of the subscales. The total STREAM score
was moderately to highly associated with the score of the
Barthel Index and Fugl-Meyer motor assessment scale,
rho = 0.67, and 0.95, respectively. The STREAM subscale
scores were closely associated with scores of the other well-
validated measures. Our results demonstrate that consistent
and valid information can be obtained from the STREAM
instrument and support its use in the value of the STREAM
evaluation of motor and mobility recovery in persons who
have experienced a stroke.
Key words: cerebrovascular accident, reproducibility of
results, movement.
J Rehabil Med 2002; 34: 20–24
Correspondence address: Dr Ching-Lin Hsieh, 7 Chun-
Shan South Road, School of Occupational Therapy, College
of Medicine, National Taiwan University, Taipei 100,
Taiwan, ROC. E-mail: mike26@ha.mc.ntu.edu.tw
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