Reliability of scores on the Stroke Rehabilitation Assessment of Movement (STREAM) measure

Abstract

Background and Purpose. The Stroke Rehabilitation Assessment of Movement (STREAM) is a new clinical measurement tool for evaluating the recovery of voluntary movement and basic mobility following stroke. This article presents the results of 3 substudies examining the reliability (interrater and intrarater) and internal consistency of STREAM scores. Subjects and Methods. A 'direct-observation reliability study' was conducted on 20 patients who had strokes and were in a rehabilitation setting. Pairs of raters from a group of 6 participating therapists provided data to judge interrater agreement. A 'videotaped assessments reliability study' was done to assess intrarater and interrater agreement on the scoring of videotaped performances using the STREAM measure and involved 4 videotaped assessments that were viewed and rated on 2 occasions by 20 physical therapists. The internal consistency of the STREAM scores was evaluated for 26 patients who had strokes and who demonstrated the full range of motor ability. Results. The reliability of the STREAM scores was demonstrated by generalizability correlation coefficients of .99 for total scores and of .96 to .99 for subscale scores. The internal consistency of the STREAM scores was demonstrated by Cronbach alphas of greater than .98 on the subscales and overall. Conclusion and Discussion. These high levels of reliability support the use of the STREAM instrument for the measurement of motor recovery following stroke. Further work on the validity and responsiveness of the STREAM measure is in progress.