title: Responsiveness of the ten-metre walk test, Step Test and Motor Assessment Scale in inpatient care after stroke.
abstract: BACKGROUND
  Responsiveness of a measurement tool is its ability to detect change over time. The aim of this study was to determine the responsiveness and floor/ceiling effects of the ten-metre walk test (10mWT), Step Test and Motor Assessment Scale (MAS) lower limb items.
  
  
  METHODS
  An inception cohort study was conducted, including 190 stroke survivors admitted to a comprehensive stroke unit. The 10mWT, Step Test and MAS were administered within 48 hours of admission and repeated in the 48 hours before discharge. Responsiveness was analysed with Effect Size (ES), Standardised Response Mean (SRM) and a median-based Effect Size (mES). Floor/ceiling effects were calculated as the percentage of participants scoring the lowest/highest possible scores.
  
  
  RESULTS
  Responsiveness of each outcome measure varied according to the statistic used. Values for the 10mWT were ES 1.44, SRM 0.93, mES 0.45; the step test ES 1.99, SRM 0.88, mES 0.36; MAS sit-to-stand (item 4) score ES 1.27, SRM 1.00, mES 0.50; and for MAS item 5 (walking) ES 1.43, SRM 1.10, mES 0.50. The MAS item 3 (sitting balance) was moderately responsive in all analyses (ES 0.72, SRM 0.71, mES 0.50). The MAS mobility score (summed items 3-5) consistently showed large responsiveness (ES 1.42, SRM 1.16, mES 0.92). The Step Test had the highest proportion of participants who didn't change (46%) and item 4 of the MAS showed the largest ceiling effect on discharge (44%).
  
  
  CONCLUSIONS
  Most measures were able to detect change in motor performance during inpatient stroke rehabilitation but the MAS mobility score was the only measure that demonstrated large responsiveness and no marked floor or ceiling effects.
authors.affiliation: Musculoskeletal Division, The George Institute of Global Health, The University of Sydney, PO Box M201 Missenden Road, Sydney 2050 NSW, Australia. kate.scrivener@mq.edu.au.
authors.forename: Katharine
authors.initials: K
authors.lastname: Scrivener
authors.forename: Karl
authors.initials: K
authors.lastname: Schurr
authors.forename: Catherine
authors.initials: C
authors.lastname: Sherrington
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D010351:Patient Discharge; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology