Tracking Changes in Participation With Participation Measurement Scale in Community-Dwelling Stroke Survivors in Africa.

Abstract

To investigate responsiveness of the Participation Measurement Scale (PM-Scale) for the measurement of participation of stroke survivors. A 6-month observational study with 3 evaluation time points. Responsiveness of the PM-Scale was investigated over a period of 6 months. Rehabilitation centers. Stroke survivors (N =64); mean age ± SD, 56.9±12.6 years; sex, 45 men (70%). Not applicable. Participants were evaluated using the PM-Scale. The modified Rankin Scale was used to categorize the overall disability level for each participant. The mixed-effect model analysis showed a significant difference in the participation over time (χ²=35.04; df=2; P<.001). In addition, the model exhibited significant effects of the sex, age, and disability at enrollment on the subjects' participation levels. Furthermore, the PM-Scale detected different levels of changes in the entire cohort over time (small change, effect size [ES]=0.33; moderate change, ES=0.67; and large change, ES=1). The PM-Scale also facilitated the classification of the participants into discriminative categories such as important improvement (t score≥1.96; 1.8≤ES≤2.13), moderate improvement (0<t score<1.96; 0.56≤ES≤0.78), no change (t score=0), moderate decrease (-1.96<t score<0; ES=0.67), and important decrease (t score≤-1.96; ES=1.47). The PM-Scale exhibited good responsiveness and accurately detected changes in stroke subjects' involvement in life situations. These results validate the usefulness of the PM-Scale for clinical trials and in settings to evaluate the effects of interventions on subjects with stroke in Africa.