|Siu, Yan-yan Priscilla
|Assessment of motor and process skills (AMPS) and functional performance for Chinese people suffered from stroke
|Hong Kong Polytechnic University -- Dissertations
Cerebrovascular disease -- Patients
Function tests (Medicine)
Motor ability -- Testing
|Department of Rehabilitation Sciences
|ix, 106 leaves ; 30 cm
|Different instruments are used to assess the functional performance of patients with stroke by indicating the level of independence and amount of assistance they require. Most of the instruments contain small numbers of tasks for assessment, and their ceiling or flooring effects do not allow for true reflection and prediction of individuals' abilities in daily life. The Assessment of Motor and Process Skills (AMPS) is a client-centered, task-oriented functional assessment that offers a wide range of tasks to measure the quality of a person's performance in terms of motor and process skills. The range of tasks allows the AMPS to be used to assess people from a low level of functioning to community living. The purpose of this study was to test for the content and criterion validity of the AMPS for Chinese elderly people living in Hong Kong who had suffered from stroke. The content validity began with the translation of the list of activities of daily living (ADL) tasks into Chinese and an investigation of their cultural relevancy by using an expert panel review. 10 occupational therapists with a mean working experience of 8.0 years in stroke rehabilitation were recruited as panel members, and then selected 41 ADL tasks from the list, ranging from personal activities of daily living (PADL) to instrumental activities of daily living (IADL) with a varied difficulty level from -0.4 to 0.9 logits in task challenges of the AMPS. The content validity of the 16 AMPS motor and 20 AMPS process skill item measures were also investigated by the same expert panel. All skill items were found to be valid in assessing the motor and process skills of people with stroke. The concurrent validity of the AMPS was determined by correlating the results of the AMPS with other functional performance measures. The Modified Barthel Index (MBI), Instrumental Activities Daily Living Scale (IADLS), and the Mini-mental State Examination (MMSE) were used as these criterion measures. 31 elderly people with paralysis on either side and a mean age of 70.2+-6.70 years in their pre-discharge stage of stroke rehabilitation were recruited for this study. The results showed significant moderate correlations between the AMPS motor skills and both the MBI and the IADLS (r=0.53 with MBI and r=0.46 with IADLS). The AMPS process skills had a low correlation with the MMSE (r=0.37), but a high correlation with the IADLS (r=0.77). The predictive validity of the AMPS at the pre-discharge stage on the functional performance one month post-discharge was further tested for the same subjects. Data regarding functional performance were collected through telephone interviews with the patients or their care-givers about patients' performance on the MBI and the IADLS. The AMPS motor skills were found to be a significant predictor of the MBI (R2=21%, p=0.01). For IADLS, the AMPS process skills were also found to be a significant predictor (R2=20%, p=0.01). The predictive equations proposed were found to be applicable in clinical practice. The AMPS is a valid tool for local clinical practice aimed at Chinese elderly people with stroke. More culturally relevant new tasks for widening the range of task choices offered to elderly patients are suggested.
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