PMID- 18617579
OWN - NLM
STAT- MEDLINE
DCOM- 20080904
LR  - 20091111
IS  - 1538-6724 (Electronic)
IS  - 0031-9023 (Linking)
VI  - 88
IP  - 8
DP  - 2008 Aug
TI  - Scale for contraversive pushing: cutoff scores for diagnosing "pusher behavior" 
      and construct validity.
PG  - 947-55
LID - 10.2522/ptj.20070179 [doi]
AB  - BACKGROUND AND PURPOSE: Considerable disagreement exists among researchers with 
      regard to the prevalence, pathophysiology, and treatment of "pusher behavior" 
      (PB), partly because of different testing procedures. This study was primarily 
      aimed at establishing cutoff scores for and the construct validity of the Scale 
      for Contraversive Pushing (SCP). The prevalence of PB in people with right- and 
      left-brain lesions also was investigated. SUBJECTS AND METHODS: The study 
      subjects were 105 consecutive patients with recent stroke. Two methods were used 
      to diagnose PB: clinical examination and SCP score with 3 different cutoff 
      points--an SCP total score of greater than 0 (Crit_1), subscores in each section 
      of the scale of greater than 0 (Crit_2), and subscores in each section of the 
      scale of > or =1 (Crit_3). Clinical and SCP diagnoses were independently made by 
      different examiners. The Cohen kappa coefficient was used to determine the 
      agreement between clinical and SCP diagnoses. The construct validity of the SCP 
      was estimated by calculation of Spearman rank correlation coefficients for SCP 
      and balance, mobility, and functional scores. RESULTS: The agreement between 
      clinical and SCP diagnoses was low (kappa=.212) when Crit_1 was used. Crit_2 led 
      to the highest agreement with the clinical diagnosis (kappa=.933). However, only 
      Crit_3, although globally less accurate (kappa=.754), ensured no false-positive 
      results. The construct validity of the SCP was demonstrated by significant 
      (P<.001) moderate to high correlations with mobility (rho=.595), functional 
      (rho=.632), and balance (rho=.666) scores. The prevalence of PB was not 
      influenced by the side of the lesion. A limitation of the study was that the 
      reliability of the clinical examination method was not investigated. DISCUSSION 
      AND CONCLUSION: The results support the validity of the SCP and suggest the need 
      to choose different SCP cutoff criteria (Crit_2 or Crit_3) according to the aim 
      of the evaluation.
FAU - Baccini, Marco
AU  - Baccini M
AD  - Unit of Functional Reeducation, Azienda Sanitaria di Firenze, and Motion Analysis 
      Laboratory, Piero Palagi Hospital, Florence, Italy. marco.baccini@asf.toscana.it
FAU - Paci, Matteo
AU  - Paci M
FAU - Nannetti, Luca
AU  - Nannetti L
FAU - Biricolti, Claudia
AU  - Biricolti C
FAU - Rinaldi, Lucio A
AU  - Rinaldi LA
LA  - eng
PT  - Journal Article
DEP - 20080710
PL  - United States
TA  - Phys Ther
JT  - Physical therapy
JID - 0022623
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Diagnostic Techniques, Neurological/*standards/statistics & numerical data
MH  - *Disability Evaluation
MH  - Female
MH  - Functional Laterality/*physiology
MH  - Hemiplegia/*diagnosis/physiopathology/rehabilitation
MH  - Humans
MH  - Male
MH  - Movement Disorders/*diagnosis/physiopathology/rehabilitation
MH  - Observer Variation
MH  - Predictive Value of Tests
MH  - Reproducibility of Results
MH  - Stroke/*physiopathology
EDAT- 2008/07/12 09:00
MHDA- 2008/09/05 09:00
CRDT- 2008/07/12 09:00
PHST- 2008/07/12 09:00 [pubmed]
PHST- 2008/09/05 09:00 [medline]
PHST- 2008/07/12 09:00 [entrez]
AID - ptj.20070179 [pii]
AID - 10.2522/ptj.20070179 [doi]
PST - ppublish
SO  - Phys Ther. 2008 Aug;88(8):947-55. doi: 10.2522/ptj.20070179. Epub 2008 Jul 10.