Purpose: Assess and monitor postural control for patients after stroke.

Summary: There are 12 items included in the measure that increase in difficulty. Some items are repeated to score different aspects of a movement. Each item is scored on a scale from 0-3 and the maximum score that can be achieved is 36. The exam takes approximately 10 minutes to complete.

Equipment: Stopwatch, 50 cm exam table, pen

ICF Category: Impairment and Activity

The Postural Assessment Scale for Stroke (PASS) is highly recommended for use in those with acute and subacute stroke but not recommended for use in chronic stroke populations. The PASS is highly recommended for use in acute care, inpatient rehabilitation, skilled nursing facilities, outpatient rehabilitation, and home health. This measure should be taught to students. Below are psychometrics for the PASS:

• Concurrent Validity: Acute: Excellent with BBS (ρ=0.92-0.95), Excellent with short form (ICC=0.98), Excellent with TIS (ρ=0.849); Acute to Subacute: Excellent with BBS (ICC=0.97)

• Construct Validity: Acute to Subacute: Excellent with FIM total score (r=0.73), transfer tasks (r=0.82), locomotor tasks (r=0.73), motricity of LE (r=0.78) and UE (r=0.63); Acute: Excellent correlation with Barthel Index (ρ=0.88-0.92); Excellent convergent validity with BESTest (r=0.96); Excellent convergent validity with BESTest (r=0.96)

• Cutoff Score: 3.5 for static, 8.5 for dynamic, 12.5 for total

• Floor/Ceiling Effects: Acute: Moderate floor or ceiling effect at admission

• Interrater Reliability: Acute: Excellent for total score (ICC=0.97), adequate to excellent for individual items (ICC=0.61-0.96); Acute to Subacute: Excellent for total score (ICC=0.97), adequate to excellent for individual items (ICC=0.61-0.96)

• Intrarater Reliability: Acute to Subacute: Excellent for total score (r=0.98), good for individual items (r=0.45-1)

• MDC: Acute: 1.8; Subacute: 2.22; Chronic: 3.2 (full version), 2.2 (short form)

• Responsiveness: Acute: Large responsiveness between rehab admission and discharge (SRM=1.23)

• SEM: Chronic: 1.14 full test, 0.78 for short form, Acute: 2.4

• Test-retest: Chronic: Excellent (ICC=0.84), Excellent short form (ICC=0.93)