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Measurement properties of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) using Rasch analysis.

Journal article
Authors Carina Ulla Persson
Annika Linder
Peter Hagell
Published in European journal of physical and rehabilitation medicine
Volume 53
Issue 6
Pages 848-55
ISSN 1973-9095
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Health and Rehabilitation
Pages 848-55
Language en
Keywords Patient outcome assessment, Reproducibility of results, Stroke, Rehabilitation
Subject categories Neurosciences


A previous small-sample (n=150) Rasch analysis of the Swedish modified version of the Postural Assessment Scale for Stroke Patients (SwePASS) suggested problems regarding response categories and redundant items that need confirmation in larger samples with more severe strokes.To evaluate the measurement properties of the SwePASS in patients with acute stroke.A multicentre, cross-sectional study.Two stroke units in Western Sweden.The study cohort included 250 consecutive inpatients undergoing rehabilitation after acute stroke.The SwePASS assessments were performed once within the first four days after admission to the stroke units. The data were analysed according to the Rasch measurement model regarding targeting, model fit, reliability, response category function, local dependence and differential item functioning.Postural control of 250 patients (median age, 76.5 years) was assessed with the SwePASS within median of two days after admission to the stroke units. The SwePASS covered a continuum of different levels of postural control, but had suboptimal targeting with insufficient representation of lower and higher levels of postural control. The reliability was high, the item fit statistics were generally acceptable and there was no differential item functioning by sex, age and stroke localization. However, response categories did not function as expected for four of the 12 SwePASS items and five items exhibited local dependency.The SwePASS exhibited several promising measurement properties. To improve the scale, poor targeting, illogical response categories and local dependency should be addressed.The SwePASS provides valuable clinical information regarding postural control in the acute phase after stroke.

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