The Scale for Contraversive Pushing: A Reliability and Validity Study

Abstract

Objective. Pushing toward the hemiplegic side can interfere with mobility training after stroke. This study estimated the internal consistency, interrater reliability, and validity of the Scale for Contraversive Pushing (SCP). Methods. Twenty-six patients with recent stroke were diagnosed with pusher behavior (PB). Two testers, randomly selected from 3 other examiners, independently assessed each patient using the SCP on the same day within 3 days of admission for rehabilitation. Cohen kappa coefficient was used to determine the agreement between the clinical and SCP diagnosis. The interrater reliability of the scale was estimated by calculation of the intraclass correlation coefficient. Cronbach’s alpha coefficient and Pearson’s coefficients were used to estimate the internal consistency of the scale and correlations between the subscores and the total score. Results. The agreement between SCP and clinical diagnosis was very low when the original cutoff criterion for SCP diagnosis was used but was almost perfect with a modified criterion. The interrater reliability was good to excellent with regard both to each sub-score and to the total score. The internal consistency was very high, along with correlations between subscores and total score of the scale. Conclusions. The results provide support for use of the SCP based on its reliability and validity using a modified cutoff criterion to make a diagnosis of PB.