The CMSA assesses physical impairment and disability in clients with stroke and other neurological impairment.
45-60 minutes
Adult
18 - 64
yearsElderly Adult
65 +
years|
Reviewed by Michele Sulwer, PT, DPT, NCS and Genevieve Pinto-Zipp, PT, EdD of the StrokEDGE II, Neurology Section, APTA in 3/2016 |
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
|
Abbreviations: |
|
HR |
Highly Recommend |
|
R |
Recommend |
|
LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
|
NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
|
|
Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 months post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
|
StrokEDGE |
R |
R |
R |
Recommendations based on level of care in which the assessment is taken:
|
|
Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
|
StrokEDGE |
R |
R |
UR |
R |
R |
Recommendations for entry-level physical therapy education and use in research:
|
|
Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
|
StrokEDGE |
No |
Yes |
Yes |
Not reported |
Chedoke-McMaster Stroke Assessment Measure translations:
French: http://www.physiotherapy.ca/Practice-Resources/Orders
These translations, and links to them, are subject to the Terms and Conditions of Use of the Rehab Measures Database. RIC is not responsible for and does not endorse the content, products or services of any third-party website, and does not make any representations regarding its quality, content or accuracy. If you would like to contribute a language translation to the RMD, please contact us at rehabmeasures@ric.org.
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Acute Stroke: (Gowland et al 1993; n = 32; mean age = 64; mean time since stroke onset = 9 months)
> 9 on the leg and postural control scores indicates that the individual is able to ambulate independently. (Stevenson, 1999)
Acute Stroke: (Gowland et al, 1993)
Acute Stroke: (Gowland et al, 1993)
Acute Stroke: (Gowland et al, 1993)
Acute Stroke: (Gowland et al, 1993)
Excellent concurrent validity: Fugl-Meyer (r = 0.95)
Excellent concurrent validity: FIM (r = 0.79)
Excellent concurrent validity: Barthel Index of ADLs (r = 0.75 -0.87 *Disability Index)
Poor concurrent validity with, Barthel Index: areas of shoulder pain & eating and bowel incontinence (r <0.30)
Excellent predictive validity, Physical Impairment Scale Leg postural control scores of >9 showed 100% sensitivity and 80% specificity in prediction of independent ambulation.
Excellent predictive validity, Total outcome of CMSA stroke assessment could be predicted by 7 items on the Barthel Index (R-2 = 0.75)
Predictive Equations:
Predicting Clinical Outcomes following Stroke Rehabilitation (Gowland et al, 1995):
|
Outcome Variables |
R squared |
Equation |
CI |
|
Discharge Destination |
0.38 |
5.97 – (0.06 x Gross Motor Function) – (0.21 x Bladder) |
±3.5 |
|
Length of Stay |
0.38 |
22.03–(1.18 x Leg)–(0.05 x Adult FIMSM)–(0.06 xAge) |
±6.9 |
|
Adult FIMSM |
0.65 |
39.23+(0.73 x Adult FIMSM) |
±29.6 |
|
Activity Inventory |
0.73 |
17.45+(0.88 x Gross Motor Function) + (4.30 x Leg) |
±23.3 |
|
Gross Motor Function |
0.7 |
24.94+(0.76 x Gross Motor Function)–(0.30 x Weeks) |
±16.1 |
|
Walking |
0.71 |
(Gross Motor Function x 0.28)+(Postural Control+Leg x 1.23)–4.55 |
±9.2 |
|
Shoulder Pain |
0.55 |
2.33+(0.44xShoulder Pain) + (0.28 x Arm) |
±1.6 |
|
Postural Control |
0.60 |
2.23 + (0.35 x Postural Control) + (0.3 x Leg) |
±1.3 |
|
Arm |
0.80 |
0.82+(1.03 x Arm)-(0.03 x Weeks) |
±1.5 |
|
Hand |
0.78 |
0.53+(0.98 x Hand) |
±1.5 |
|
Leg |
0.69 |
1.83+(0.77 x Leg)-(0.02 x Weeks) |
±1.5 |
|
Foot |
0.73 |
1.11+(0.90 x Foot)-(0.03 x Weeks) |
±1.3 |
Predictive Equations for Stroke Acute Care can be found http://www.chedokeassessment.ca/Default.aspx?tabid=531
Acute Stroke: (Gowland et al, 1993)
CMSA Activity Inventory and the Functional Independence Measure (FIM) convergent validity evidence:
Moreland, Gowland, Van Hullenar, and Huijbregts (1993) performed a literature review to gather evidence for a theoretical basis of the Chedoke-McMaster Stroke Assessment. All items from both inventories had enough scientific evidence supporting its assumptions. Thus, the authors were able to establish a theoretical basis underlying the content of the Chedoke-McMaster Stroke Assessment.
The CMSA Disability Inventory is more sensitive to the FIM at detecting clinically important change. (Gowland et al, 1993)
Gowland, C., Stratford, P., et al. (1993). "Measuring physical impairment and disability with the Chedoke-McMaster Stroke Assessment." Stroke 24(1): 58. Find it on PubMed
Huijbregts, M., Gowland, C., et al. (2000). "Measuring clinically-important change with the activity inventory of the Chedoke McMaster Stroke Assessment." Physiotherapy Canada 52(4): 295-304.
Morland, J., Gowland, C., et al. (1993). "Theoretical basis of the Chedoke-McMaster Stroke Assessment." Physiotherapy Canada 45: 231-231.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.