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REPAS, a summary rating scale for resistance to passive movement: item selection, reliability and validity.
Thomas Platz1, P Vuadens, Christel Eickhof
1Neurological Rehabilitation Centre (NRZ) Greifswald, Ernst-Moritz-Arndt-Universität, Greifswald, Germany. t.platz@nrz-greifswald.de
Disability and Rehabilitation
|September 14, 2007
Summary
The Resistance to Passive Movement Scale (REPAS) demonstrates high reliability and validity for assessing spasticity in neurological patients. This scale aids in evaluating impairment and activity limitations, offering a dependable measure for clinical use.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Assessment
Background:
- Spasticity is a common impairment following neurological injury, significantly impacting patient function and quality of life.
- Accurate and reliable assessment tools are crucial for monitoring spasticity and guiding treatment interventions.
- Existing scales may have limitations in comprehensiveness or psychometric properties.
Purpose of the Study:
- To develop and validate the Resistance to Passive Movement Scale (REPAS) for assessing spasticity.
- To evaluate the item characteristics and selection process for the REPAS.
- To determine the internal consistency, inter-rater, and test-retest reliability of the REPAS and its subtests.
- To examine the association between REPAS scores and other established clinical measures of impairment and activity limitation.
Main Methods:
- Thirty-three neurological patients with central paresis participated in the study.
- Two independent raters administered the REPAS assessments with a one-week interval.
- Concurrent assessments included the Motricity Index, Box-and-Block test, Functional Ambulation Category, Timed walking, Barthel Index, Disability Rating Scale, Carer Burden Scale, and Hygiene Score.
Main Results:
- Twenty-six of 52 initial REPAS items met selection criteria, forming the final version.
- The REPAS demonstrated high internal consistency, inter-rater reliability (0.87-0.97), and test-retest reliability.
- Reliability for arm and leg subtests was substantial (correlation coefficients: arm 0.63-0.98, leg 0.56-0.96).
- REPAS scores showed moderate associations with basic ADL competence, carer burden, and spasticity severity.
- A moderately high association was found between REPAS scores, arm subtest scores, arm paresis, and manual dexterity.
Conclusions:
- The REPAS, guided by Ashworth scale-based criteria, ensures consistent administration and scoring.
- The REPAS is established as a reliable and valid summary rating scale for quantifying resistance to passive movement in neurological patients.
- The scale's psychometric properties support its use in clinical practice for assessing spasticity and its functional consequences.
