Tracking Changes in Participation With Participation Measurement Scale in Community-Dwelling Stroke Survivors in Africa
Objective: To investigate responsiveness of the Participation Measurement Scale (PM-Scale) for the measurement of participation of stroke survivors. Design: A 6-month observational study with 3 evaluation time points. Responsiveness of the PM-Scale was investigated over a period of 6 months. Setting: Rehabilitation centers.
Participants: Stroke survivors (N Z64); mean age SD, 56.912.6 years; sex, 45 men (70%). Interventions: Not applicable. Main Outcome Measures: Participants were evaluated using the PM-Scale. The modified Rankin Scale was used to categorize the overall disability level for each participant. Results: The mixed-effect model analysis showed a significant difference in the participation over time (c2Z35.04; dfZ2; P<.001). In addition, the model exhibited significant effects of the sex, age, and disability at enrollment on the subjects’ participation levels. Furthermore, the PM-Scale detected different levels of changes in the entire cohort over time (small change, effect size [ES]Z0.33; moderate change, ESZ0.67; and large change, ESZ1). The PM-Scale also facilitated the classification of the participants into discriminative categories such as important improvement (t score1.96; 1.8ES2.13), moderate improvement (0<t score<1.96; 0.56ES0.78), no change (t scoreZ0), moderate decrease (1.96<t score<0; ESZ0.67), and important decrease (t score1.96; ESZ1.47).
Conclusions: The PM-Scale exhibited good responsiveness and accurately detected changes in stroke subjects’ involvement in life situations. These results validate the usefulness of the PM-Scale for clinical trials and in settings to evaluate the effects of interventions on subjects with stroke in Africa. Archives of Physical Medicine and Rehabilitation 2018;99:2238-43
ª 2018 by the American Congress of Rehabilitation Medicine