Affiliations: [a]
Pate Rehabilitation Medical Center, Dallas, TX, USA
| [b]
University of Texas Southwestern Medical Center, Dallas TX, USA
| [c]
Indiana University School of Medicine and Rehabilitation Hospital of Indiana, Indianapolis, IN, USA
Correspondence:
[*]
Address for correspondence: Carlos Marquez de la Plata, Director of Rehabilitation Research, Pate Rehabilitation Medical Center, 2655 Villa Creek Drive, Suite 140, Dallas, TX 74254, USA. Tel.: +1 972 241 9334; Fax: +1 972 484 4739; E-mail: [email protected].
Abstract: BACKGROUND: Transfer of skills learned within the clinic environment to patients’ home or community is important in post-inpatient brain injury rehabilitation (PBIR). Outcome measures used in PBIR assess level of independence during functional tasks; however, available functional instruments do not quantitate the environment in which the behaviors occur. OBJECTIVE: To examine the reliability and validity of an instrument used to assess patients’ functional abilities while quantifying the amount of structure and distractions in the environment. METHODS: 2501 patients who sustained a traumatic brain injury (TBI) or cerebrovascular accident (CVA) and participated in a multidisciplinary PBIR program between 2006 and 2014 were identified retrospectively for this study. The PERPOS and MPAI-4 were used to assess functional abilities at admission and at discharge. Construct validity was assessed using a bivariate Spearman rho analysis A subsample of 56 consecutive admissions during 2014 were examined to determine inter-rater reliability. Intra-class correlation coefficient (ICC) and Kappa coefficients assessed inter-rater agreement of the total PERPOS and PERPOS subscales respectively. RESULTS: The PERPOS and MPAI-4 demonstrated a strong negative association among both TBI and CVA patients. Kappa scores for the three PERPOS scales each demonstrated good to excellent inter-rater agreement. The ICC for overall PERPOS scores fell in the good agreement range. CONCLUSION: The PERPOS can be used reliably in PBIR to quantify patients’ functional abilities within the context of environmental demands.
