A comparison of responsiveness and predictive validity of two balance measures in patients with stroke

Objective: To compare the responsiveness and predictive validity of the Balance Computerized Adaptive Test (Balance CAT ) and the Postural Assessment Scale for Stroke patients (PASS) in inpatients with stroke receiving rehabilitation. Design: A pre-post test design. Subjects: Eighty-five inpatients after stroke. Methods: Effect size d and Wilcoxon signed-rank test were used to assess the internal responsiveness of the Balance CAT and PASS. The changes in the Barthel Index (BI) and the mobility subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) scores were both chosen as the external criteria for examining external responsiveness. Moreover, to investigate the predictive validity, the admission scores of the two balance measures, and the discharge score of the BI/MO-STREAM, were examined by simple linear regression analysis. Results: Both the Balance CAT and PASS had high internal responsiveness (effect size d ≥ 0.87) and fair external responsiveness (r2 ≥ 0.20). The predictive validities of both measures were sufficient (r2 ≥ 0.33). The Balance CAT took approximately 3 items (min-max = 2-4) to complete. Conclusion: The Balance CAT and PASS have sufficient responsiveness and predictive validity in inpatients with stroke receiving rehabilitation. The Balance CAT is more efficient to administer and is thus recommended over the PASS.