Abstract
Study design
Psychometric study.
Objectives
The Standing and Walking Assessment Tool (SWAT) is a standardized approach to the evaluation of standing and walking capacity following traumatic spinal cord injury (tSCI) in Canada. The SWAT classifies individuals with a tSCI into 12 stages of standing and walking capacity that are paired with well-established outcome measures, such as the Berg Balance Scale and 10-m Walk Test. Prior research has demonstrated the validity and responsiveness of the SWAT stages; however, the reliability remains unknown. The objective of this study was to evaluate the interrater reliability of the SWAT stages.
Setting
Inpatient units of two Canadian rehabilitation hospitals.
Methods
Adults with sub-acute tSCI were recruited. SWAT stage was evaluated for each participant by two physical therapists separately. The two therapists aimed to complete the evaluations within one day of each other. To evaluate interrater reliability, the percentage agreement between the SWAT stages rated by the two physical therapists was calculated, along with a linear weighted kappa statistic with a 95% CI.
Results
Forty-five individuals with sub-acute tSCI (36 males, 9 females, mean (SD) age of 54.8 (17.9) years) participated. The percentage agreement in SWAT stages between the two physical therapists was 75.6%. A kappa statistic of 0.93 with a 95% CI, 0.81–1.05 was obtained. In cases where therapists disagreed (18% of participants), therapists differed by 1–2 stages only.
Conclusions
The SWAT stages have high interrater reliability, providing further support for the use of the SWAT in rehabilitation practice in Canada.
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Data availability
All data generated or analyzed during this study are included in this published article.
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Acknowledgements
Thank you to the physical therapists who participated as assessors: Chelsea Wong, Gillian Johnston, Marissa Constand, Marianne Cossette-Levasseur, Daniel Badra, Andrea Moreau, Catherine Dansereau, Josée Jubinville, Philippe Ménard, and Christiane Garneau.
Funding
This study was funded by the Praxis Spinal Cord Institute.
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KEM, KW, JFL and DHG conceptualized the study. KC and JFL were responsible for data collection. KC, SN and KEM analyzed the data. SN and KEM wrote the manuscript. KC, KW, JFL and DHG reviewed and provided edits to the manuscript.
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Ngan, S., Lemay, JF., Chan, K. et al. Interrater reliability of the Standing and Walking Assessment Tool for spinal cord injury. Spinal Cord 61, 556–561 (2023). https://doi.org/10.1038/s41393-023-00921-2
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DOI: https://doi.org/10.1038/s41393-023-00921-2