The Physical Performance Test and the evaluation of functional status in patients with cerebral aneurysms

Abstract

Cerebral aneurysms can adversely affect the functional status of patients who harbor them through rupture, mass effect, or treatment sequela. The authors compared the Physical Performance Test (PPT)--an observer-administered test requiring the completion of seven tasks--with three functional status measures based on patient self-reports: the Glasgow Outcome Scale (GOS), the modified Rankin Scale (mRS), and the modified Barthel Index (mBI). Data were collected from 144 patients with aneurysms who had been recruited from a neurosurgery clinic. The patients completed the PPT and were assigned GOS scores, mRS scores, and mBIs based on their responses during a structured interview. The validity of the PPT was assessed by examining the relationship between the results of the PPT and the values assigned to each patient by using the GOS, mRS, and mBI by applying rank-order methods; the reliability of the PTT was assessed using the Cronbach alpha coefficient. The mean age of the patients was 52.8 years; 72% were women and 54% had survived a subarachnoid hemorrhage. The mean +/- standard deviation PPT score was 24.0 +/- 3.7. The PPT generated a broad distribution of scores, whereas GOS and mRS scores and mBIs displayed significant ceiling effects, that is, 75% of the patients were clustered in the highest categories. The PPT scores were validated by their strong association with GOS scores, mRS scores, and mBIs (for all, p < 0.001), and the reliability of the PPT was demonstrated by a Cronbach alpha value of 0.77. The PPT provides an objective measure of functional status in patients with cerebral aneurysms. The results suggest that the PPT may differentiate among patients better than the GOS, mRS, or mBL The PPT is a valid and reliable instrument for measuring functional status in patients with cerebral aneurysms.