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Scale for contraversive pushing: cutoff scores for diagnosing "pusher behavior" and construct validity
Marco Baccini1, Matteo Paci, Luca Nannetti
1Unit of Functional Reeducation, Azienda Sanitaria di Firenze, and Motion Analysis Laboratory, Piero Palagi Hospital, Florence, Italy. marco.baccini@asf.toscana.it
Physical Therapy
|July 12, 2008
Summary
Researchers established cutoff scores for the Scale for Contraversive Pushing (SCP) to diagnose pusher behavior (PB). The SCP demonstrated construct validity, aiding in patient assessment after stroke.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Assessment
Background:
- Disagreement exists regarding pusher behavior (PB) prevalence, pathophysiology, and treatment due to varied testing methods.
- Standardized assessment tools are needed to accurately diagnose PB in stroke patients.
Purpose of the Study:
- Establish cutoff scores and construct validity for the Scale for Contraversive Pushing (SCP).
- Investigate the prevalence of PB in patients with right- and left-brain lesions.
Main Methods:
- 105 stroke patients were assessed using clinical examination and the SCP with three cutoff criteria (Crit_1, Crit_2, Crit_3).
- Cohen kappa coefficient measured agreement between clinical and SCP diagnoses.
- Spearman rank correlation coefficients assessed SCP construct validity against balance, mobility, and functional scores.
Main Results:
- The SCP showed low agreement with clinical diagnosis using Crit_1 (kappa=.212).
- Crit_2 yielded the highest agreement (kappa=.933), while Crit_3 ensured no false positives (kappa=.754).
- SCP demonstrated significant construct validity, correlating highly with mobility, function, and balance scores (P<.001).
Conclusions:
- The Scale for Contraversive Pushing (SCP) is a valid tool for assessing pusher behavior (PB).
- Different SCP cutoff criteria (Crit_2 or Crit_3) should be selected based on the evaluation's specific goals.
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