Physiotherapy - Theses
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ItemThe Melbourne pusher scale: a reliability and validity study( 2003)The pushing phenomenon in stroke patients has been more extensively researched in recent years. Previous studies have concentrated on examining the incidence, causes and functional outcome for these patients, however, the validity for this research has been questioned due to the lack of use of a psychometrically sound assessment scale for pushing. The first aim of the current study was to develop a clear, concise, ordinal pushing scale, the Melbourne Pusher Scale, that would measure the severity of pushing in acute stroke patients. The second aim was to determine the reliability and validity of the Melbourne Pusher Scale in measuring the pushing phenomenon. The study involved 30 acute stroke patients for the inter-rater reliability and validity studies, 20 acute stroke patients for the intra-rater reliability, and 15 control subjects for the validity study. The Melbourne Pusher Scale was found to have strong inter-rater reliability (Kappa statistic= 0.91) as well as strong intra-rater reliability (Kappa statistic= 0.92). The investigation of concurrent validity of the scale found the Melbourne Pusher Scale to have some validity. Further research using video analysis in a larger sample may aid in the validation of this scale. Not only is the Melbourne Pusher Scale the first such scale to have psychometric analysis documented, it is the first reliable scale that measures the severity of pushing. The Melbourne Pusher Scale may aid in future research into the cause and management of the pushing phenomenon, more accurate clinical decision-making and the effective use of relevant health care resources for these acute stroke patients.