***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background and Purpose — This study compared the psychometric properties of 3 clinical balance measures , the  Berg Balance Scale ( BBS ) , the Balance subscale of the Fugl-Meyer test ( FM-B ) , and the Postural Assessment Scale for Stroke Patients ( PASS ) , in stroke patients with a broad range of neurological and functional impairment from the acute stage up to 180 days after onset . Methods — One hundred twenty-three stroke patients were followed up prospect ively with the 3 balance measures 14 , 30 , 90 , and 180 days after stroke onset ( DAS ) . Reliability ( interrater reliability and internal consistency ) and validity ( concurrent validity , convergent validity , and predictive validity ) of each measure were examined . A comparison of the responsiveness of each of the 3 measures was made on the basis of the entire group of patients and 3 separate groups classified by degree of neurological severity . Results — The FM-B and BBS showed a significant floor or ceiling effect at some DAS points , whereas the PASS did not show these effects . The BBS , FM-B , and PASS all had good reliability and validity for patients at different recovery stages after stroke . The results of effect size demonstrated fair to good responsiveness of all 3 measures within the first 90 DAS but , as expected , only a low level of responsiveness at 90 to 180 DAS . The PASS was more responsive to changes in severe stroke patients at the earliest period after stroke onset , 14 to 30 DAS . Conclusions — All 3 measures tested showed very acceptable levels of reliability , validity , and responsiveness for both clinicians and research ers . The PASS showed slightly better psychometric characteristics than the other 2 measures Objective The primary objective of this study was to develop a quantitative test to assess ambulation in multiple sclerosis ( MS ) patients that is more accurate and sensitive than the Timed 25-foot walk ( T25FW ) . For this purpose , we developed the Six Spot Step Test ( SSST ) , which besides speed includes co-ordination and balance , to be a lower limb counterpart to the 9-Hole Peg Test ( 9HPT ) . Background The T25FW , which is the ambulation test of the MS Functional Composite ( MSFC ) , reflects only the speed component of walking . The lack of sensitivity to other components of gait adds to the floor effect . Methods and patients In the SSST , the patient is instructed to walk as quickly as possible from one end to the other of a rectangular field measuring 1 × 5 m , while kicking five cylinder blocks out of five circles marked on the floor . Some 151 MS patients with the Exp and ed Disability Status Scale ( EDSS ) score 0 - 6.5 and 64 normal controls performed the SSST and the T25FW . In addition , 41 patients performed the tests twice . Results The range of the SSST  ( 4.7 - 35.1 seconds ) was wider than that of the T25FW ( 3.5 - 22.6 seconds ) . Using control mean+ 2 SD as cut off , 107 patients had abnormal SSST , while 100 patients had abnormal T25FW . The T25FW ( mean ) increased 2.1 seconds over the EDSS range of 0 - 4.0 , while the SSST increased 4.9 seconds . The intra-class correlation between repeated tests ( r ) was 0.95 for the SSST and 0.96 for the T25FW . The correlation between the SSST and the T25FW was high ( r=0.92 ) . Conclusion The SSST seems to be superior to the T25FW in terms of dynamic range , floor effect and discriminatory power . The SSST is a relevant alternative for the T25FW as the ambulation component of the MSFC Background The COSMIN checklist is a tool for evaluating the method ological quality of studies on measurement properties of health-related patient-reported outcomes . The aim of this study is to determine the inter-rater agreement and reliability of each item score of the COSMIN checklist ( n = 114 ) . Methods 75 articles evaluating measurement properties were r and omly selected from the bibliographic data base compiled by the Patient-Reported Outcome Measurement Group , Oxford , UK . Raters were asked to assess the method ological quality of three articles , using the COSMIN checklist . In a one-way design , percentage agreement and intraclass kappa coefficients or quadratic-weighted kappa coefficients were calculated for each item . Results 88 raters participated . Of the 75 selected articles , 26 articles were rated by four to six participants , and 49 by two or three participants . Overall , percentage agreement was appropriate ( 68 % was above 80 % agreement ) , and the kappa coefficients for the COSMIN items were low ( 61 % was below 0.40 , 6 % was above 0.75 ) . Reasons for low inter-rater agreement were need for subjective judgement , and accustom to different st and ards , terminology and definitions . Conclusions Results indicated that raters often choose the same response option , but that it is difficult on item level to distinguish between articles . When using the COSMIN checklist in a systematic review , we recommend getting some training and experience , completing it by two independent raters , and reaching consensus on one final rating . Instructions for using the checklist are improved Background and Purpose — This study compared the validity , responsiveness , and interrater reliability of 3 mobility measures in stroke patients from the acute stage up to 180 days after stroke onset . The 3 measures were the  Rivermead Mobility Index ( RMI ) , a modified RMI ( MRMI ) , and the  Mobility Subscale of the Stroke Rehabilitation Assessment of Movement ( STREAM ) . Methods — The validity and responsiveness of the 3 mobility measures were prospect ively examined by monitoring 57 stroke patients with the measures and the Barthel Index at 14 , 30 , 90 , and 180 days after stroke onset . Two individual raters used the 3 measures to evaluate a different sample of 40 patients on 2 separate occasions to determine the interrater reliability . Results — The Spearman & rgr ; between STREAM and MRMI was ≥0.92 ; the intraclass correlation coefficient ( ICC , a measure of agreement ) between them was ≥0.89 , indicating high concurrent validity of both measures . RMI showed a moderate to high relationship and agreement with STREAM and MRMI ( & rgr;≥0.78 , ICC≥0.5 ) . Responsiveness of the 3 measures was high before 90 days after stroke onset ( st and ardized response mean ≥0.83 ) and low at 90 to 180 days after stroke onset ( 0.2≤st and ardized response mean≤0.4 ) . The score changes of the 3 measures at each stage were significant ( P ≤0.05 ) , except for RMI and MRMI at 90 to 180 days after stroke onset . The interrater agreement of the 3 measures was high ( ICC≥0.92 ) . Conclusions — All 3 measures examined showed acceptable levels of reliability , validity , and responsiveness in stroke patients . The psychometric characteristics of STREAM were slightly superior to those of the other 2 measures among our patients . We prefer and recommend STREAM for measuring mobility disability in stroke patients Background and Purpose — We compared the test-retest reliability , validity , and responsiveness of the Dynamic Gait Index , the 4-item Dynamic Gait Index , and the Functional Gait Assessment for assessment of walking in patients with stroke . Methods — Forty-five out patients participating in the validity and responsiveness study were tested using the 3 walking measures as well as the 10-m walk test , Barthel Index , and Postural Assessment Scale for Stroke Patients .  We tested them during the first week , then again after 2 months and 5 months of therapy .  Another 48 chronic patients completed the 3 measures twice , 1 week apart , in the test-retest reliability study . Results — Thirty-five participants completed 3 time-point assessment s. The Functional Gait Assessment showed the least floor and ceiling effects , indicating it has the best discriminative ability for patients with stroke with high walking function . We found the 3 measures were highly correlated with each other , indicating excellent concurrent validity , and all measures at the first week of therapy were moderately to highly correlated with the Barthel Index scores at 5 months , indicating good predictive validity . Responsiveness of the 3 measures was moderate during a 5-month period , and all showed good test-retest reliability . The minimal detectable changes between tests indicate acceptable r and om error . Conclusions — All 3 measures showed sufficient validity , responsiveness , and reliability for assessment of walking function in patients with stroke undergoing rehabilitation , but the Functional Gait Assessment is recommended for its psychometric properties Study design : The 10-m walk test ( 10MWT ) and the 6-min walk test ( 6MWT ) have been recommended for assessment of walking in spinal cord injury ( SCI ) patients . The study was design ed on test – retest analysis of the 10MWT and 6MWT . Objectives : The objective of this study was to assess validity/reliability of different methods of performing the tests . Setting : The study was set at an SCI unit of a rehabilitation hospital . Patients and methods : A total of 37 patients ; whose median age was 58.5 years ( interquartile range 40–66 , full range 19–77 ) ; median time since onset of SCI was 24 months ( interquartile range 16.25–70.5 , full range 6–109 ) . Non-traumatic etiology in 20 out of 37 patients ; level : 12C , 14 T and 11L ; American Spinal Injury Association Impairment Scale grade : 35D/2C . Assessment with the 10MWT ( with or without dynamic start ) and the 6MWT ( short or long track ) by two blinded raters to evaluate inter/intra-rater reliabilities . Results : The  10MWT  was performed in a median of 19 s ( 25th–75th interquartile range 13–28 ) with the dynamic start and of 18.4 s ( 25th–75th interquartile range 12.6–29.9 ) with the static start ( P=0.092 ) . The correlation between the results of the two methods was between 0.98 and 0.99 . The inter- and intra-rater reliabilities were between 0.95 and 0.99 for both the methods . The 6MWT showed significant differences according to the track length : patients walked a median of 226.7 m ( 25th–75th interquartile range 123.2–319 ) on the longer track and of 187.6 m ( 25th–75th interquartile range 69.7–240.6 ) on the short one ( P<0.001 ) . The correlation between the results of the two methods was between 0.91 and 0.93 . The inter- and intra-rater reliabilities were between 0.98 and 0.99 . Conclusion : The 10MWT shows high inter/intra-rater reliability and shows comparable results with both dynamic and static start . The different testing conditions of the 6MWT ( track/turns ) results in significant differences that need st and ardization for use in future trials Background The minimal detectable change ( MDC ) is the smallest amount of difference in individual scores that represents true change ( beyond r and om measurement error ) . The MDCs of the Timed “ Up & Go ” Test ( TUG ) and the Dynamic Gait Index ( DGI ) in people with Parkinson disease ( PD ) are largely unknown , limiting the interpretability of the change scores of both measures . Objective The purpose of this study was to estimate the MDCs of the TUG and the DGI in people with PD . Design This investigation was a prospect i ve cohort study . Methods Seventy-two participants were recruited from special clinics for movement disorders at a university hospital . Their mean age was 67.5 years , and 61 % were men . All participants completed the TUG and the DGI assessment s twice , about 14 days apart . The MDC was calculated from the st and ard error of measurement . The percentage MDC ( MDC% ) was calculated as the MDC divided by the mean of all scores for the sample . Furthermore , the intraclass correlation coefficient was used to examine the reproducibility between testing sessions ( test-retest reliability ) . Results The respective MDC and MDC% of the TUG were 3.5 seconds and 29.8 , and those of the DGI were 2.9 points and 13.3 . The test-retest reliability values for the TUG and the DGI were high ; the intraclass correlation coefficients were .80 and .84 , respectively . Limitations The study sample was a convenience sample , and the participants had mild to moderately severe PD . Conclusions The results showed that the TUG and the DGI have generally acceptable r and om measurement error and test-retest reliability . These findings should help clinicians and research ers determine whether a change in an individual patient with PD is a true change OBJECTIVES To estimate the magnitude of small meaningful and substantial individual change in physical performance measures and evaluate their responsiveness . DESIGN Secondary data analyses using distribution- and anchor-based methods to determine meaningful change . SETTING Secondary analysis of data from an observational study and clinical trials of community-dwelling older people and subacute stroke survivors . PARTICIPANTS Older adults with mobility disabilities in a strength training trial ( n=100 ) , subacute stroke survivors in an intervention trial ( n=100 ) , and a prospect i ve cohort of community-dwelling older people ( n=492 ) . MEASUREMENTS  Gait speed , Short Physical Performance Battery ( SPPB ) , 6-minute-walk distance ( 6MWD ) , and self-reported mobility . RESULTS Most small meaningful change estimates ranged from 0.04 to 0. 
    Output:
    
Results / Discussion : Based on survey results , the CPG focuses on OMs that have acceptable clinical utility and can be used to assess change over time in a patient 's balance , gait , transfers , and patient-stated goals .
Strong , level I evidence supports the use of the Berg Balance Scale to assess changes in static and dynamic sitting and st and ing balance and the Activities-specific Balance Confidence Scale to assess changes in balance confidence .
Strong to moderate evidence supports the use of the Functional Gait Assessment to assess changes in dynamic balance while walking , the 10 meter Walk Test to assess changes in gait speed , and the 6-Minute Walk Test to assess changes in walking distance .
Best practice evidence supports the use of the 5 Times Sit-to-St and to assess sit to st and ing transfers .
Evidence was insufficient to support use of a specific OM to assess patient-stated goals across adult neurologic conditions .