The PRPS is a clinician-rated instrument designed to assess a patient's participation in therapy.
1
5 minutes
Per session
Adult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by the Rehabilitation Measures Team; Updated by Anna de Joya PT, MS, NCS and the TBI EDGE task force of the Neurology section of the APTA in 2012.
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: |
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HR | Highly Recommend |
R | Recommend |
LS / UR | Reasonable to use, but limited study in target group / Unable to Recommend |
NR | Not Recommended |
Recommendations based on level of care in which the assessment is taken:
| Acute Care | Inpatient Rehabilitation | Skilled Nursing Facility | Outpatient Rehabilitation | Home Health |
TBI EDGE | NR | NR | NR | NR | NR |
Recommendations for use based on ambulatory status after brain injury:
| Completely Independent | Mildly dependant | Moderately Dependant | Severely Dependant |
TBI EDGE | N/A | N/A | N/A | N/A |
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) |
TBI EDGE | No | No | No | Not reported |
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Stroke, Other Neurological Disorders, & Orthopedic Pathologies: (Iosa et al., 2021; n = 32; age ≥ 18; mean age = 60.3 (18) years; patients receiving physical therapy in neurorehabilitation hospital: stroke (37.5%), other neurological disorders (28.1%), orthopedic pathologies (34.4%); SEM calculated using the average standard deviation of two therapists first sessions; Italian translation of PRPS)
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Stroke, Other Neurological Disorders, & Orthopedic Pathologies: (calculated from Iosa et al., 2021; Italian translation of PRPS)
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Acute In-Patient: (Lenze et al, 2004; n=242; diagnoses: elderly with neurologic, (eg, stroke), orthopedic (eg, fracture, joint replacement), or debility)
These cut offs were based on visual examination of the distribution and natural breaks in the data.
Acute Inpatients: (Lenze et al, 2004, n = 242; various diagnosis admitted for inpatient rehabilitation)
Acute Rehabilitation patients: ( Paolucci et al, 1012: n=348; mean age 59.41± 12.85, diagnoses: CVA, orthopedic , lower limb amputation.)
PRPS mean score
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| Mean late score |
CVA patients | 3.77±1.02 | 4.17±0.98 |
Orthopedic patients | 4.17±0.86 | 4.30±0.89 |
P value | Z=3.92 P=0.000 | Z=4.68 P=0.000 |
Acute Inpatients: (Lenze et al, 2004; Three occupational therapists and five physical therapists participated, 2 therapists independently rated each patient’s therapy session)
Stroke, Other Neurological Disorders, & Orthopedic Pathologies: (Iosa et al., 2021; inter-rater reliability assessed by having 26 of the 32 patients further evaluated in their first session by a second therapist blind to the scoring of the first, while intra-rater reliability was assessed by a single therapist separately evaluating the 10 first and 10 last sessions of 32 patients; Italian translation of PRPS)
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Stroke, Other Neurological Disorders, & Orthopedic Pathologies: (Iosa et al., 2021; Italian translation of PRPS)
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Predictive validity: Acute Inpatients: (Lenze et al, 2004)
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Acute Inpatients: (Lenze et al, 2004)
PRPS Scores and Motor FIM Change in the 3 Impairment Subgroups |
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Group | n | PRPS Mean (SD) | Motor FIM Change Mean (SD) | Bivariate Correlation |
Debility | 73 | 4.55 (0.70) | 20.3 (8.5) | .34* |
CVA | 38 | 4.62 (0.93) | 23.0 (10.4) | .51† |
Elective hip/knee | 56 | 4.96 (0.60) | 25.0 (6.4) | .11 |
Entire group | 242 | 4.73 (0.76) | 22.0 (8.8) | .32† |
*p = .01 |
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Stroke in Acute in-patient rehab: (Skidmore et al, 2010; n=44; mean age=73.6 (7.9); stroke onset, days=9.1(7.3))
Measure | PRPS (r) |
Digit Span | -.12 |
HVLT | .11 |
Executive Interview | -.55* |
Hamilton Rating Scale for Depression | -.39* |
Apathy Evaluation Scale | -.27 |
FIM, baseline | .56* |
Time (days since stroke) | -.30 |
*p <.01
To ensure the measure demonstrated adequate psychometric properties, developers conducted interviews with therapists as well as observed therapy sessions to better quantify different levels of participation
Community Dwelling Adults: (Talkowski et al, 2009; n = 18, participants all >60 years old; Longitudinal with three and six month follow-ups)
Characteristics of Participants by Facility Type: |
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| IRFs (n = 16) | SNFs (n = 2) |
Age in years (mean) | 78.0 | 86.0 |
Minutes in therapy (mean) | 150.0 | 75.5 |
Activity counts per minute (median) | 36.8 | 48.2 |
PRPS scores (mean) | 5.0 | 5.2 |
Baseline HFRS (mean) | 95.6 | 93.5 |
IRF = Inpatient Rehabilitation Facilities |
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Predictive validity: Older Adults & Geriatric Care: (Morghen et al., 2017; n = 556; mean age w/poor functional gain at discharge = 81.6 (7.4) years; mean age w/good functional gain at discharge = 78.2 (6.7) years; functional gain evaluated using the Montebello rehabilitation factor score (MRFS efficacy): good vs. poor functional gain = above or below median MRFS efficacy value for whole sample, respectively)
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Hip Fracture: (Munin, 2005, n = 42 inpatient rehabilitation facilities, 34 = skilled nursing facilities; hip fracture patients undergoing rehabilitation, patients > 60 years old, had surgical stabilization of the fracture, and were living in the community when the fracture sustained)
Baseline Demographics and Clinical Measures: |
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| Inpatient rehabilitation facilities |
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| Skilled nursing facilities |
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Demographics | n | mean (SD) | min / max | n | mean (SD) | min / max |
Age (years) | 42 | 80.2 (8.4) | 61 / 94 | 34 | 83.9 (9.4) | 63 / 105 |
Female (%) | 35 | 83.3 |
| 27 | 79.4 |
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White (%) | 40 | 95.2 |
| 30 | 88.2 |
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Social support | 41 | 18.5 (9.9) | 2 / 37 | 32 | 13.5 (6.9) | 1 / 31 |
Cognitive measures |
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MMSE | 41 | 25.2 (3.8) | 16 / 30 | 34 | 23.0 (5.3) | 9 / 30 |
HAMD | 41 | 9.5 (5.2) | 2 / 24 | 33 | 11.6 (5.9) | 4 / 26 |
Delirium Rating Scale | 41 | 5.8 (5.7) | 2 / 24 | 33 | 8.3 (6.6) | 2 / 26 |
Clinical measures |
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CIRS | 38 | 9.2 (3.1) | 3 / 18 | 31 | 10.2 (2.9) | 5 / 16 |
Rehabilitation participation | 37 | 4.6 (0.8) | 2.1 / 6 | 22 | 4.3 (1.1) | 2.4 / 6 |
Hospital LOS | 40 | 5.0 (1.9) | 2 / 12 | 31 | 6.4 (3.7) | 3 / 21 |
Rehabilitation LOS | 36 | 12.8 (6.9) | 4 / 38 | 24 | 36.2 (20.5) | 15 / 90 |
min / max = minimum and maximum scores
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Lenze, E. J., Munin, M. C., et al. (2004). "The Pittsburgh Rehabilitation Participation Scale: reliability and validity of a clinician-rated measure of participation in acute rehabilitation." Archives of Physical Medicine and Rehabilitation, 85(3): 380-384. Find it on PubMed
Losa, M., Galeoto, G., De Bartolo, D., et al., (2021). Italian version of the Pittsburgh Rehabilitation Participation Scale: Psychometric analysis of validity and reliability. Brain Sciences, 11(5): 626. https://doi.org/10.3390/brainsci11050626
Morghen, S., Morandi, A., Guccione, A. A., et al., (2017). The association between patient participation and functional gain following inpatient rehabilitation. Aging Clin Exp Res, 29(4): 729-736. http://doi.org/10.1007/s40520-016-0625-3
Munin, M. C., Seligman, K., et al. (2005). "Effect of rehabilitation site on functional recovery after hip fracture." Archives of Physical Medicine and Rehabilitation, 86(3): 367-372. Find it on PubMed
Paolucci, S., Di Vita, A., et al. (2012). "Impact of participation on rehabilitation results: a multivariate study." Eur J Phys Rehabil Med 48(3): 455-466. Find it on PubMed
Talkowski, J. B., Lenze, E. J., et al. (2009). "Patient participation and physical activity during rehabilitation and future functional outcomes in patients after hip fracture." Archives of Physical Medicine and Rehabilitation, 90(4): 618-622. Find it on PubMed
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.