1. Measurement in CVA Addendum slides

2. Wonderful resource McGill University in Canada has a website called the Stroke Engine. It has best evidence for a variety of interventions, as well as a wide host of interventions. http://www.strokengine.ca/ http://www.medicine.mcgill.ca/strokengine-assess/

3. Barthel Index A study just published in Stroke (vol 42, 2011) by Kwakkel, Verbeek, et al. reported that Day 5 post stroke is the earliest time this test can be used to make an optimal prediction of functional outcomes of ADLs at 6 months.

4. More on the Berg… It has been tested with persons with stroke. It has also been evaluated to determine the MDC (minimal detectable change) needed to demonstrate genuine change in performance. – A change of 6 points is necessary to be 90% confident of true change.

5. New Balance Assessment Horak and colleagues developed a new test of balance called the BESTest (Balance Evaluation Systems Test) which has been evaluated for psychometric quality. A new, shortened version of the test has been developed (from 36 to 14 items) and takes only 10-15 minutes to complete. (Please see Journal of Rehabilitation Medicine 2010: 42: 323-331.)

6. Sitting balance measure There is also a new sitting balance assessment called the FIST (Function in Sitting Test) which was just published in JNPT, volume 34, Sept 2010, pp. 150-160. There are 14 items included in the test, such as – Sitting with eyes closed – Pick object up off floor – Lateral scooting without using arms – Maximum score is 56

7. The Four Square Step Test The Four Square Step Test is an easy to use, dynamic test of standing balance that has been tested with persons after stroke. It has been found to be reliable, as well as sensitive to change. It is recommended ONLY for persons with stroke who can walk at least 50 meters with minimal assistance or less. Preliminary data suggest increased risk of falls for persons requiring more than 15 seconds to complete the test.

8. Additional gait speed info Additional research on the 6MWT suggested a change of 54.1m for persons undergoing inpatient rehabilitation.* MDC change for gait speed in individuals undergoing inpatient rehabilitation was determined to be 0.30 m/sec (59 ft/min).** Other research has shown that a change of.18 m/s was significant at 20 days post stroke and.39 m/s was significant at 60 days post onset.