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Published on: September 1, 2023
Practice effect and reliability of the motor-free visual perception test-4 over multiple assessments in patients with
En-Chi Chiu1, Jen-Wen Hung2,3, Min-Yuan Yu2
1Department of Long-Term Care, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Purpose:
The Motor-Free Visual Perception Test-4 (MVPT-4) is a multidimensional measure of visual perception with five subscales (visual discrimination, figure-ground, visual memory, spatial relationships, and visual closure). The purpose of this study was to examine practice effect and test-retest reliability of the MVPT-4 over four serial assessments in patients with stroke.
Methods:
We recruited outpatients with stroke with age above 20 years, able to follow instructions, and able to sign informed consent. We excluded patients who had visual neglect and visual deficits (e.g., diplopia, cataract, and glaucoma). Sixty patients completed the MVPT-4 four times, one week apart. Cumulative and plateau phases of the practice effect were evaluated across four assessments. Test-retest reliability was examined using the intraclass correlation coefficient (ICC).
Results:
The MVPT-4 scale and five subscales showed cumulative phases. Only the spatial relationships subscale may have reached a plateau phase at the second assessment. The ICC values of the MVPT-4 scale and five subscales were 0.48-0.87. The minimum and maximum values of the 90% confidence interval (CI) of reliable change index modified for practice (RCIp) were: MVPT-4 scale [-5.0, 7.7]; visual discrimination [-1.7, 2.1]; figure-ground [-2.0, 2.6]; visual memory [-2.6, 3.2]; spatial relationships [-2.3, 3.0]; and visual closure [-2.5, 2.8].
Conclusions:
The MVPT-4 scale and five subscales appeared increasing trends of practice effects and moderate to excellent test-retest reliability in patients with stroke. The minimum and maximum values of the 90% CI RCIp for the spatial relationships subscale which may have reached a plateau phase that can help clinicians and researchers to ascertain whether the real score change is occurred for an individual patient.Implications for rehabilitationThree multilevel regression models were conducted to evaluate the plateau phase of the practice effect over four assessments.The patterns of practice effects and evidences of test-retest reliability of the MVPT-4 scale and five subscales over four serial assessments can be used to follow the progress of patients with stroke.The minimum and maximum values of the 90% CI RCIp of the MVPT-4 can assist clinicians and researchers to explain score changes for an individual patient with stroke.
Insights
The Motor-Free Visual Perception Test-4 (MVPT-4) shows practice effects and reliable test-retest scores in stroke patients. These findings aid clinicians in tracking patient progress and interpreting score changes.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Psychometrics
Background:
- Visual perception deficits are common after stroke, impacting daily functioning.
- The Motor-Free Visual Perception Test-4 (MVPT-4) is a key assessment tool for evaluating visual perception.
- Understanding the psychometric properties of the MVPT-4 in specific populations, like stroke survivors, is crucial for accurate assessment.
Purpose of the Study:
- To investigate practice effects across four serial administrations of the MVPT-4 in stroke patients.
- To determine the test-retest reliability of the MVPT-4 and its subscales in this population.
- To provide data that can help clinicians and researchers interpret score changes over time.
Main Methods:
- Sixty outpatient stroke survivors completed the MVPT-4 four times, one week apart.
- Practice effect phases (cumulative and plateau) were analyzed across the four assessments.
- Test-retest reliability was quantified using the intraclass correlation coefficient (ICC).
Main Results:
- The MVPT-4 and its subscales demonstrated cumulative practice effects.
- The spatial relationships subscale showed a potential plateau effect by the second assessment.
- Intraclass correlation coefficients (ICC) ranged from 0.48 to 0.87, indicating moderate to excellent reliability.
Conclusions:
- The MVPT-4 exhibits practice effects and moderate to excellent test-retest reliability in stroke patients.
- Reliable change index (RCIp) values can assist in determining meaningful score changes for individual patients.
- Findings support the use of the MVPT-4 for monitoring visual perception progress in stroke rehabilitation.
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