London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 765 793 Rehabilitation and reorganisation after stroke Reliability, measurement error and sensitivity to change of time-limited walk tests in people with stroke: A systematic review N.M. Salbach1, K. O’Brien2, D. Brooks3, E. Irvin4, R. Martino5, P. Takhar6, S. Chan7, J. Howe8 Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CANA-DA1, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CANA-DA2, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CANA-DA3, Institute for Work & Health, Toronto, CANADA4, Department of Speech-Language Pathology, University of Toronto, Toronto, CANADA5, Department of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, CANADA6, Toronto Western Hospital-University Health Network, Toronto, CANADA7, Toronto Rehabilitation Institute-University Health Network, Toronto, CANA-DA8 Background: Our aim was to provide an overview of the reliability, measurement error and sen-sitivity to change of time-limited walk tests in people with stroke. Methods: We conducted a sys-tematic review of the research literature. We searched seven electronic databases up to January 2012 using tailored search strategies. Two authors independently screened titles and abstracts. One author reviewed full-text articles to determine inclusion using specified criteria. One author ap-praised the methodological quality of included studies. Results: Of the 4,139 citations screened, 14 met the inclusion criteria. Studies evaluated five unique time-limited walk tests including the two-, three-, five-, six- and twelve-minute walk tests (2-, 3-, 5-, 6- and 12MWT, respectively). The number of studies evaluating reliability, measurement error and sensitivity to change was 11, eight, and one study, respectively. For each test, the type and magnitude of reliability estimates, based on the intraclass correlation coefficient (ICC), were: 2MWT (intra-rater) ICC=1.00; 3MWT (test-re-test) ICC=0.90; 5MWT (test-retest) ICC=0.97; 6MWT (inter/intra-rater) ICC=0.99/0.99; 6MWT (test-retest) ICC=0.96–0.99; and 12MWT (inter/intra-rater) ICC=0.68/0.71. Inter/intra-rater reli-ability of distances at 2 and 6 minutes from a 12MWT were: 2MWT ICC=0.85/0.85, and 6MWT ICC=0.78/0.74. Minimal detectable change (MDC95%) for the 6MWT was 33.0-54.1m. The stan-dardized response mean (SRM) for the 12MWT and distances derived at 2 and 6 minutes was 1.90, 1.34 and 1.52, respectively. Conclusion: Excellent reliability (ICC ≥0.75) was observed across walk tests among people with stroke except for the 12MWT. Estimates of MDC suggest that substantial improvement in 6MWT distance is necessary to surpass measurement error. The 12MWT and de-rived distances show excellent (SRM>0.8) sensitivity to change in one study suggesting these tests would be optimal to monitor effects of walking re-training among adults with stroke. 794 Rehabilitation and reorganisation after stroke Experiences of Psychological Distress amongst Stroke Survivors C. Crowe1, J. Harbison2, R. Coen3, N. Kidd4, D. Hevey5, S. Walsh6 Trinity College Dublin, Dublin, IRELAND1, The Adeilade and Meath Hospital, Dublin, IRE-LAND2, The Adeilade and Meath Hospital, Dublin, IRELAND3, The Adeilade and Meath Hospital, Dublin, IRELAND4, Trinity College Dublin, Dublin, IRELAND5, The Adeilade and Meath Hospital, Dublin, IRELAND6 Background: Psychological distress post-stroke is common with studies showing that approximately one third of stroke survivors will experience psychological problems including clinical depression and anxiety (Hackett et al., 2005). Qualitative research has provided important insights that have facilitated greater depth of understanding of the psychological problems in the aftermath of stroke. The purpose of this research was to explore the lived experiences of stroke survivors with psycho-logical distress. Method: Semi-structured interviews with 10 stroke survivors were analyzed using the principles of Interpretative Phenomenological Analysis (IPA). All participants scored in the clin-ical range for psychological distress, defined as above clinical threshold on the Hospital Anxiety and Depression Scale (HADS) total scale score. Results: Three super-ordinate themes (“The invisible enemy” The fear of stroke; “The house is not the same” The loss of self; and “It’s murderous be-ing on my own” The anguish of aloneness) emerged. Processes involving a lack of acceptance and self-compassion were found to underline these themes. Discussion: Results are discussed with refer-ence to theoretical models of stroke. Suggestions are made as to the potential importance of a lack of acceptance and self-compassion in understanding psychological distress post-stroke. Theoretical and clinical implications are outlined.
Karger_ESC London_2013
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