Postural Assessment Scale For Stroke Research Articles

The Postural Assessment Scale for Stroke Patients: translation into Norwegian, cultural adaptation, and examination of reliability

Background: To translate the Modified Swedish version of Postural Assessment Scale for Stroke (SwePASS) into Norwegian (SwePASS-NV) and assess its intra- and interrater reliability.Methods: Translation and cross-cultural adaptation was accomplished according to international guidelines. Forty-seven adults, suffering a stroke within the last 6 months, were strategically recruited and allocated into groups according to five different levels of function. Their performance on SwePASS-NV was video-recorded and then scored by three raters twice, with a minimum of 4 weeks between sessions. Relative reliability was investigated by calculating intraclass correlation coefficients (ICC1.1 and ICC3.1). Absolute reliability was analysed using within-subject SD (Sw) and smallest detectable difference (SDD). For individual items, Cohen’s kappa (k) and percentage of agreement were calculated.Results: The study showed excellent intra- and interrater reliability (ICC1.1 and ICC3.1 ≥0.99) for SwePASS-NV. K-values for the individual items ranged between 0.68 and 1.00. Percentages of agreement ranged from 77% to 100%. SDD at 95% confidence interval was ≤2 points for intrarater assessments and ≤3 points for interrater assessments.Conclusions: This study demonstrated very high intra- and interrater reliability of the SwePASS-NV in adults within the first 6 months after stroke. All items showed very high or high agreement.

Hemorrhagic versus ischemic stroke: Who can best benefit from blended conventional physiotherapy with robotic-assisted gait therapy?

BackgroundContrary to common belief of clinicians that hemorrhagic stroke survivors have better functional prognoses than ischemic, recent studies show that ischemic survivors could experience similar or even better functional improvements. However, the influence of stroke subtype on gait and posture outcomes following an intervention blending conventional physiotherapy with robotic-assisted gait therapy is missing.ObjectiveThis study compared gait and posture outcome measures between ambulatory hemorrhagic patients and ischemic patients, who received a similar 4 weeks’ intervention blending a conventional bottom-up physiotherapy approach and an exoskeleton top-down robotic-assisted gait training (RAGT) approach with Lokomat.MethodsForty adult hemiparetic stroke inpatient subjects were recruited: 20 hemorrhagic and 20 ischemic, matched by age, gender, side of hemisphere lesion, stroke severity, and locomotor impairments. Functional Ambulation Category, Postural Assessment Scale for Stroke, Tinetti Performance Oriented Mobility Assessment, 6 Minutes Walk Test, Timed Up and Go and 10-Meter Walk Test were performed before and after a 4-week long intervention. Functional gains were calculated for all tests.ResultsHemorrhagic and ischemic subjects showed significant improvements in Functional Ambulation Category (P<0.001 and P = 0.008, respectively), Postural Assessment Scale for Stroke (P<0.001 and P = 0.003), 6 Minutes Walk Test (P = 0.003 and P = 0.015) and 10-Meter Walk Test (P = 0.001 and P = 0.024). Ischemic patients also showed significant improvements in Timed Up and Go. Significantly greater mean Functional Ambulation Category and Tinetti Performance Oriented Mobility Assessment gains were observed for hemorrhagic compared to ischemic, with large (dz = 0.81) and medium (dz = 0.66) effect sizes, respectively.ConclusionOverall, both groups exhibited quasi similar functional improvements and benefits from the same type, length and frequency of blended conventional physiotherapy and RAGT protocol. The use of intensive treatment plans blending top-down physiotherapy and bottom-up robotic approaches is promising for post-stroke rehabilitation.

Long-term follow-up of a randomized controlled trial on additional core stability exercises training for improving dynamic sitting balance and trunk control in stroke patients

Objective: Analyse the effect of core stability exercises in addition to conventional physiotherapy training three months after the intervention ended. Design: A randomized controlled trial. Setting: Outpatient services. Subjects: Seventy-nine stroke survivors. Interventions: In the intervention period, both groups underwent conventional physiotherapy performed five days/week for five weeks, and in addition the experimental group performed core stability exercises for 15 minutes/day. Afterwards, during a three-month follow-up period, both groups underwent usual care that could eventually include conventional physiotherapy or physical exercise but not in a controlled condition. Main measures: Primary outcome was trunk control and dynamic sitting balance assessed by the Spanish-Version of Trunk Impairment Scale 2.0 and Function in Sitting Test. Secondary outcomes were standing balance and gait evaluated by the Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Spanish-Version of Postural Assessment Scale for Stroke and activities of daily living using the Barthel Index. Results: A total of 68 subjects out of 79 completed the three-month follow-up period. The mean difference (SD) between groups was 0.78 (1.51) points (p = 0.003) for total score on the Spanish-Version of Trunk Impairment Scale 2.0, 2.52 (6.46) points (p = 0.009) for Function in Sitting Test, dynamic standing balance was 3.30 (9.21) points (p= 0.009) on the Berg Balance Scale, gait was 0.82 (1.88) points (p = 0.002) by Brunel Balance Assessment (stepping), and 1.11 (2.94) points (p = 0.044) by Tinetti Test (gait), all in favour of core stability exercises. Conclusions: Core stability exercises plus conventional physiotherapy have a positive long-term effect on improving dynamic sitting and standing balance and gait in post-stroke patients.

Efficiency of physical therapy on postural imbalance after stroke: study protocol for a systematic review and meta-analysis

IntroductionStroke frequently results in balance disorders, leading to lower levels of activity and a diminution in autonomy. Current physical therapies (PT) aiming to reduce postural imbalance have shown a large...

Effects of the Sensory Feedback training for Improving Postural Balance after the Stroke

Objectives: This study aims to investigate the effect of sensory feedback training for improving on postural balance after the stroke. Methods/Statistical Analysis: The subjects were 10 stroke patients, who has problem with hemiplegia. The patients were divided into two groups: The Sensory feedback Group (SG) and Conservative Group (CG). Sensory feedback for improving on postural balance was carried out twenty times, five times a week for four-weeks, together with 30 minutes preservative treatment. Also in CG, only the preservative treatment was carried out. To compare the groups, we used several assessment tools; MTD without vision, MTD with vision for the static postural balance and Postural Assessment Scale for Stroke (PASS). Findings: In SG, sensory feedback was significantly improved MTD1, MTD2 and PASS (p<.05). Also, there was significantly differences in MTD1 and MTD2 between both groups (p<.05). Improvements/Applications: The sensory feedback is influenced for improving of the ability of postural balance. Therefore, we consider that the sensory feedback would contribute for improving of recovery of postural control to be based on functional activities in rehabilitation.

Efficiency of physical rehabilitation on postural imbalance after stroke: Systematic review and meta-analysis

Balance disorders are frequently seen after stroke resulting in limited physical activities. The effects of current physical rehabilitations aiming at reducing postural imbalance are varied with low levels of evidence. Objectives: i) to determine the efficiency of physical rehabilitation methods on the recovery of postural imbalance in patients after stroke; ii) to assess which method is more effective when compared with one another. Search strategy: we searched Medline , Embase , Pedro , Cochrane Central Register of Controlled Trials , Pascal and Francis from inception to October 2015. All published and unpublished studies and conferences were searched. Selection criteria: – randomised controlled trials; – physical rehabilitation methods aiming at recovering postural imbalance; – in adults with stroke. Outcome measures were: the Berg Balance Scale (BBS), the Postural Assessment Scale for Stroke (PASS), static posturographic parameters (in sitting or standing conditions) and all other measurements of weight bearing distribution. : two authors (AH, JDM) independently screened the articles on title, abstract and finally on full study report, according to our selection criteria. The methodological quality of studies was evaluated and the data were extracted. In addition to outcomes, measures of independence in activities of daily living (ADL) and the Barthel index (BI) were extracted. Subgroup analyses are planned according to the location of brain lesions (hemispheric, brainstem or cerebellum), the type of approaches (top-down or bottom-up), the methodological quality of studies and the overall time of rehabilitation. We identified 9937 relevant studies. We excluded 8093 on titles, 1364 on abstracts and 294 on full study reports. Finally, 186 studies were included. The interest is to determine the effects of all physical rehabilitation methods: i) not only on the postural parameters (posturography), but also on the limitations of activity (BBS, PASS) and on the independence of patients (IB, AVQ); ii) and according to the location of the brain lesions, in order to adapt the strategies of rehabilitation.

Active mobility early after stroke. A randomised controled trial (AMOBES)

Active and intensive physical therapy (PT) facilitates motor recovery when provided at a subacute stage after stroke. The efficiency of very early intensive PT (within the 2 first weeks) has been much less investigated. Early intensive rehabilitation might be beneficial for neural plasticity but also detrimental by worsening the cerebral ischemia. The AVERT study (Bernhardt 2015) showed negative effect of high dose of very early mobilisation. Patients have been recruited in this multicentre randomized controlled trial (9 stroke units with PRM teams) to compare “soft” (20 min/day apart from respiratory needs) versus “intensive” PT (idem + 45 minutes of intensive exercises/day), initiated within the 72 first hours after a first hemispheric stroke. Blind assessment has been made. The primary criterion was the motor control assessed by the Fugl Meyer score at D90. Secondary criteria were: Fugl Meyer at D15, D30, D45, postural balance (postural assessment scale for stroke), autonomy (rankin and functional independence measure) at D15, D30, D45, D90, unexpected medical events, length of hospital stay, quality of life (stroke impact scale) at D90. The study has been approved by the local ethics committee n o 2011/37, registered on clinical trial.gov NCT01520636. One hundred and three of the 104 included patients could be analysed, 64 males, 67 right hemispheric lesions, 80 ischemic lesions, NIHSS < 8 in 19 patients, 8-15 in 42, > 15 in 42; age 66.2 ± 13/67.2 ± 11. No significant difference between groups was observed for the primary criterion (median: 41.5 [14;76] versus 54 [22;80], p = 0.32), neither for any of the secondary criteria. The number of unexpected medical events was the same in the two groups. The sub-group analysis, for the primary as for the secondary criteria, according to the 3 groups of severity, the side of the lesion, thrombolysis, or type of stroke did not show any difference. The results of the RCT (AMOBES) confirm previous studies. Very early intensive exercises after stroke are not more effective on motor recovery than a soft PT preventing immobility related complications.

The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial

Objective: To examine the effect of core stability exercises on trunk control, dynamic sitting and standing balance, gait, and activities of daily living in subacute stroke patients. Design: A randomized controlled trial. Setting: Inpatient rehabilitation hospital in two centres. Subjects: Eighty patients (mean of 23.25 (±16.7) days post-stroke) were randomly assigned to an experimental group and a control group. Interventions: Both groups underwent conventional therapy for five days/week for five weeks and the experimental group performed core stability exercises for 15 min/day. The patients were assessed before and after intervention. Main measures: The Trunk Impairment Scale (Spanish-Version) and Function in Sitting Test were used to measure the primary outcome of dynamic sitting balance. Secondary outcome measures were standing balance and gait as evaluated via Berg Balance Scale, Tinetti Test, Brunel Balance Assessment, Postural Assessment Scale for Stroke (Spanish-Version), and activities of daily living using Barthel Index. Results: The experimental group showed statistically significant differences for all of the total scale scores (P<0.05), except for the sitting section of the Brunel Balance Assessment. The mean (SD) difference between groups in Trunk Impairment Scale total score was 3.40 (±4.12) points, and its subscale dynamic sitting balance was 2.28 (±3.29). The Berg Balance Scale was 14.54 (±18.19) points, and the Barthel Index was 13.17 (±25.27) points. Collectively, these results were in favour of the experimental group. Conclusions: Core stability exercises in addition to conventional therapy improves trunk control, dynamic sitting balance, standing balance, gait and activities of daily living in subacute post-stroke patients.

Discriminative Ability and Predictive Validity of Postural Assessment Scale for Stroke as Independent Ambulation for Chronic Stroke Patients

Discriminative Ability and Predictive Validity of Postural Assessment Scale for Stroke as Independent Ambulation for Chronic Stroke Patients

An exploration of trunk reposition error in subjects with acute stroke: An observational design

Background & Objective: Trunk reposition error (TRE) is a component of trunk control, yet has not been reported in acute stroke. The purpose of this study was to quantify TRE in acute stroke and report this with related rehabilitation outcomes.Methods: Sixty subjects, 30 with acute stroke and 30 healthy controls, completed this study. Subjects with acute stroke were measured before and after an in-patient acute rehabilitation stay.Measures: TRE using an electromagnetic tracking device, Berg Balance Scale, Postural Assessment Scale for Stroke, and Functional Independence Measures. Pre-post measures were analyzed with paired t-tests. Between-group measures were analyzed with independent w-tests.Results: There were significant between group differences (acute stroke vs. controls) for all functional outcome measures (P < 0.001) and for three-dimensional TRE (P = 0.001). There were significant improvements in all functional outcome measures following an in-patient rehabilitation stay (P < 0.001). All measures of TRE reduced but did not achieve significance.Conclusion: TRE was not as severely impaired as anticipated and was variable based on plane of measure. Time in a rehabilitation setting produced significant improvements in functional outcomes but TRE improvements were not as robust. These results indicate a need for further investigation of the strength of the interrelationship between TRE and function.

A Study on Core Stability Training for Postural Control Ability and Respiratory Function in Patients with Chronic Stroke

The purpose of this study was to examine the effects of the core-stability training on postural control ability and respiratory function in patients with chronic stroke. 30 subjects were randomly assigned to 2 groups. Experimental group (n=15) received core-stability training and control group (n=15) received general exercise. Each program was performed 30 min, 4 times a week for a period of 8 weeks.Core-stability training included a therapeutic program to train abdominal muscle strength. General exercise include weight bearing and weight shifts and joint movements to improve flexibility and the range of motion. For all 30 subject, the items measured before the training were measured after the therapeutic intervention. To observe postural control changes, we measured maintenance & change of posture, balance and coordination ability with postural assessment scale for stroke (PASS) and trunk impairment scale (TIS). The respiratory functions were measured forced vital capacity (FVC), forced expiratory volume at one second (FEV1) using spirometer. After training, the PASS and TIS scores was significantly improved in experimental group (p<.05), and the experimental group showed significantly difference from control group (p<.05). In respiratory function test, experimental group more significantly increased than before (p<.05), and showed significantly difference from control group (p<.05). The results of this study showed that the core-stability training may be appropriate for improving the trunk stability and respiratory function in chronic stroke patients.

Construction and pilot assessment of the Lower Limb Function Assessment Scale.

Stroke often leads to upright standing and walking impairments. Clinical assessments do not sufficiently address ecological aspects and the patient's subjective evaluation of function. To perform a pilot assessment of the psychometric properties of the Lower Limb-Function Assessment Scale (LL-FAS). The LL-FAS includes 30 items assessing the patient's perception (in a questionnaire) and the examiner's perception (in a practical test) of upright standing and walking impairments and their impact on activities of daily living. We analyzed the LL-FAS's reliability, construct validity, internal consistency, predictive validity and feasibility. Thirty-five stroke patients were included. The scale's mean ± SD completion time was 25 ± 6 min. Intra-observer reliability was good to excellent (intraclass correlation coefficients (ICC >0.82). Interobserver reliability was moderate (0.67 < ICC < 0.9). The questionnaire and test items showed excellent construct validity for neuromotor disabilities (p < 0.05), postural ability (Postural Assessment Scale for Stroke; p < 10-5), severity of gait disorders (Gait Assessment and Intervention Tool; p < 10-3), walking ability (New Functional Ambulation Categories, 10 m walk test, Rivermead Mobility Index; p < 10-3) and functional level (Barthel Index; p < 10-3). Internal consistency (Cronbach-α >0.9) and predictive validity were excellent. The LL-FAS showed fair psychometric properties in this pilot study and may be of value for evaluating post-stroke lower limb impairment.

The Validity of the Modified Postural Assessment Scale for Stroke and Berg Balance Scale in Predicting Fall of Subacute Stroke Patients

The Validity of the Modified Postural Assessment Scale for Stroke and Berg Balance Scale in Predicting Fall of Subacute Stroke Patients

The Reliability and Validity of the Modified Postural Assessment Scale for Stroke(Korean Version)in Stroke Patients

The Reliability and Validity of the Modified Postural Assessment Scale for Stroke(Korean Version)in Stroke Patients

Reliability and validity of the Balance Evaluation Systems Test (BESTest) in people with subacute stroke.

The Balance Evaluation Systems Test (BESTest) is a new clinical balance assessment tool, but it has never been validated in patients with subacute stroke. The purpose of this study was to examine the reliability and validity of the BESTest in patients with subacute stroke. This was an observational reliability and validity study. Twelve patients participated in the interrater and intrarater reliability study. Convergent validity was investigated in 70 patients using the Berg Balance Scale (BBS), Postural Assessment Scale for Stroke (PASS), Community Balance and Mobility Scale (CB&M), and Mini-BESTest. The receiver operating characteristic curve was used to calculate the sensitivity, specificity, and accuracy of the BESTest, Mini-BESTest, and BBS in classifying participants into low functional ability (LFA) and high functional ability (HFA) groups based on Fugl-Meyer Assessment motor subscale scores. The BESTest showed excellent intrarater reliability and interrater reliability (intraclass correlation coefficient=.99) and was highly correlated with the BBS (Spearman r=.96), PASS (r=.96), CB&M (r=.91), and Mini-BESTest (r=.96), indicating excellent convergent validity. No floor or ceiling effects were observed with the BESTest. In contrast, the Mini-BESTest and CB&M had a floor effect in the LFA group, and the BBS and PASS demonstrated responsive ceiling effects in the HFA group. In addition, the BESTest showed high accuracy as the BBS and Mini-BESTest in separating participants into HFA and LFA groups. Whether the results are generalizable to patients with chronic stroke is unknown. The BESTest is reliable, valid, sensitive, and specific in assessing balance in people with subacute stroke across all levels of functional disability.

Balance and walking after three different models of stroke rehabilitation: early supported discharge in a day unit or at home, and traditional treatment (control)

ObjectiveTo compare the effects on balance and walking of three models of stroke rehabilitation: early supported discharge with rehabilitation in a day unit or at home, and traditional uncoordinated treatment...

뇌졸중 환자의 체간조절, 균형능력에 기계적 승마치료가 미치는 영향

본 연구는 기계적 승마치료가 뇌졸중 환자의 체간조절, 균형능력에 미치는 영향을 평가하기 위해 실시되었다. 본 연구에 15명의 뇌졸중 환자가 참여하였다. 연구 대상은 뇌줄중 환자를 실험군과 대조군으로 각각 7명, 8명씩 무작위로 배정하였다. 모든 환자들은 보존적 물리치료를 받았으며, 실험군에게 추가적으로 기계적 승마치료를 30분동안 시행하였다. 연구는 2013년 3월 4일부터 5월 3일 까지 약 8주간 진행되었다. 본 연구의 평가 도구는 체간조절 검사, 뇌졸중 자세조절 검사, 버그 균형 척도, 일어나서 걷기 검사였다. 측정은 중재 전, 후로 실시하였다. 중재 후 군내에서 실험군과 대조군의 체간조절 검사, 뇌졸중 자세조절 검사, 버그 균형 척도, 일어나서 걷기 검사의 중재 전, 후 값에서 유의한 차이를 보였다(p<.05). 실험군은 중재 전, 후 차이값이 체간조절 검사, 뇌졸중 자세조절 검사, 버그 균형 척도, 일어나서 걷기 검사에서 각각 <TEX>$27.85{\pm}19.03$</TEX>, <TEX>$6{\pm}4.04$</TEX>, <TEX>$19.28{\pm}4.27$</TEX>, <TEX>$16.68{\pm}4.61$</TEX> 향상되었고, 대조군에서는 각각 <TEX>$17.87{\pm}18.3$</TEX>, <TEX>$2{\pm}2.07$</TEX>, <TEX>$7.62{\pm}6.75$</TEX>, <TEX>$3.21{\pm}1.75$</TEX> 향상되었다. 두 군간의 중재 후의 평가 비교에서 중재 후 체간조절 감사, 뇌졸중 자세조절 검사, 버그 균형 척도, 일어나서 걷기 검사에서 유의한 차이가 있었다(p<.05). 이는 기계적 승마치료가 뇌졸중 환자의 체간조절 능력, 균형 능력에 긍정적인 영향을 미치는 것을 의미하여 앞으로 이러한 연구결과를 일반화시키는 것이 필요할 것이라고 사료된다. The purpose of this study was to determine the effect of mechanical horseback riding training on trunk control, balance function in stroke patients. 15 stroke patients were recruited for this study. The subjects were randomly assigned to two groups: experimental(n=7) and control(n=8). All subjects received a routine physical therapy. The mechanical horseback riding training was for 30 min in the case of the EG subjects. This study was carried out approximately 8 weeks from March 4 to May 3. The assessment tools of this study involved the trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test. The measurements were recorded before the intervention and after the intervention. In the cases of the EG subjects and CG subjects, the variables measured after the intervention significantly differed from trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test before the intervention (p<.05). Also, there were significant differences in trunk control test, postural assessment scale for stroke, Berg balance scale and timed up and go test at post test between the 2 groups (p<.05). The findings indicate that mechanical horseback riding training exerts a positive effect on trunk control, balance function in stroke patients. Further studies are required to generalize the result of this study.

Development and evaluation of the Primary Healthcare-based Physiotherapy Intervention and its effects on selected indices of stroke recovery

Aim: To develop a Primary Healthcare-Based Physiotherapy Intervention (PHCPI) that requires simple, inexpensive, easy-to-use equipment for stroke rehabilitation and evaluate its effects on selected clinical indices of recovery among post-acute stroke survivors over a 10-week period. Methods: Three databases (Medline, Pubmed and PEDro) were used to identify treatment approaches with proven efficacy. The authors synthesised these treatment approaches to develop the PHCPI, which was used in a repeated measure design involving 25 (mean age=60.6 ± 10.2 years) consenting individuals with first-incidence stroke. These individuals were treated at a primary health centre, twice weekly for 10 consecutive weeks. Outcomes were assessed using the Modified Motor Assessment Scale (MMAS), the Short Form Postural Assessment Scale for Stroke (SF-PASS) and the Reintegration to Normal Living Index (RNLI), before the intervention and fortnightly thereafter. Walking speed and quality of life were also assessed before the intervention and at week 10 of it. Results: Within-subject multivariate analysis, after controlling for gender, showed a significant increase in motor function, postural balance, walking speed and quality of life. Their community reintegration scores also improved over the period. Conclusion: The PHCPI resulted in improved motor function, community reintegration, walking speed, postural balance and quality of life among community-dwelling stroke survivors. This intervention can be used for stroke rehabilitation at primary health centres.

Stroke rehabilitation: should physiotherapy intervention be provided at a primary health care centre or the patients’ place of domicile?

Purpose: This randomized controlled trial compared the outcomes of physiotherapy intervention on selected indices of recovery for stroke survivors treated at a primary health centre group (PHCG) with those treated in their respective places of domicile group (DG). Methods: Participants were 52 individuals comprising 24 males and 28 females who had suffered a stroke and were recently discharged from two inpatient health facilities in Ibadan, Nigeria. They were randomly assigned into either the PHCG (n = 25) or DG (n = 27) and treated twice weekly for 10 consecutive weeks using a physiotherapy intervention protocol comprising a battery of task-specific exercises. The outcomes measured were motor function, balance and handicap assessed using the modified motor assessment scale (MMAS), short-form postural assessment scale for stroke (SF-PASS) and reintegration to normal living index (RNLI), respectively, as well as walking speed which was assessed using a standard technique. Results: Between-group comparison using the General Linear Model revealed no statistically significant difference in both the pre- and post-intervention scores of the two groups on the MMAS, SF-PASS, RNLI and walking speed in both PHCG and DG (p > 0.05). However, within-group comparison yielded a statistically significant difference in each of the indices of stroke recovery measured across the 10-week period in both groups. Conclusion: Physiotherapy intervention at the primary health care centre and respective homes of stroke survivors similarly improved clinical outcomes. Treatment at any of these locations may enhance access to physiotherapy after stroke in a low-income community like Nigeria.Implications for RehabilitationPhysiotherapy protocol comprising 10-week task-specific battery of exercises produced significant improvement in walking speed, balance, motor function and community reintegration of stroke survivors.Physiotherapy post-stroke can be provided at either a primary health centre or the domicile of the individual.In a low-income country like Nigeria, this will enhance access to this important service.

A Comparison of Two Balance Measures to Predict Discharge Performance From Inpatient Stroke Rehabilitation

To compare the admission Berg Balance Scale (BBS) and Postural Assessment Scale for Stroke (PASS) in predicting outcomes at discharge from an inpatient rehabilitation unit (IRU). We hypothesized that discharge outcomes would be better predicted by (1) the PASS compared with the BBS, and (2) by the PASS changing position subscore compared with the PASS maintain posture subscore. A retrospective study. An IRU in an academic medical center. Fifty-five subjects with stroke and mean (standard deviation [SD]) age of 71.5 ± 13.8 years, admission functional independence measures (FIM) of 57.2 ± 17.2 points, and IRU length of stay of 17.3 ± 9.7 days. METHODOLOGY/MAIN OUTCOME MEASUREMENTS: Admission and discharge BBS and PASS scores, gait velocity (GV) at discharge, and selected FIM items at discharge were measured. GV was analyzed both as a continuous and categorical variable. The Spearman rank correlation coefficient (r) was strong between admission BBS and PASS (r = 0.90, P < .0001). Correlations between admission BBS and PASS and discharge GV were 0.32 (P = .03) and 0.28 (P = .06), respectively. Analysis of variance was significant for both balance measures when grouped by the discharge gait speed category (P < .0001). Pairwise comparisons were significant between GV-A and the other 2 categories but not between GV-B and GV-C. The magnitude of the observed correlation with discharge GV was greater for PASS maintain posture subscore (r = 0.35, P = .02) than for PASS changing position subscore (r = 0.23, P = .13). Both subscores were significantly associated with both toileting and transfers (r = 0.43-0.56, all at least P ≤ .001). Contrary to our hypotheses, the BBS and PASS performed equally well in our study sample and were best at predicting patients discharged in the slowest GV category. There were few differences between the PASS subscores. Further research should compare how well admission BBS and PASS predict gait velocity, falls, and other functional parameters in the community after IRU discharge.