Validation of a test assessing functional capacity in stroke survivors: UCSD performance-based skills assessment (UPSA)

Abstract

Everyday functioning is an important outcome that is evaluated and targeted in stroke rehabilitation programs. Therefore, it is important to identify assessments of functional capacity that are feasible, acceptable and valid to predict daily life abilities among stroke survivors. The purpose of the present study was to determine the feasibility, acceptability and validity of the UCSD Performance-Based Skills Assessment (UPSA) in a stroke population. Participants were 40 stroke survivors, 22 Caregivers, and 20 Healthy Controls. The UPSA was validated against the Executive Function Performance Test (EFPT), a valid measure of daily functioning in stroke survivors, and Social Participation was measured using the Assessment of Life-Habits Scale (LIFE-H) which was completed by the stroke survivor's caregiver. Significant correlations were found between UPSA total and EPFT total scores, UPSA Communication and EFPT Telephone scores, and UPSA Household Management and EFPT Simple Cooking scores. However, no significant correlation was found between the UPSA Finance and the EFPT Bill Payment scores. Additionally, stroke survivors' Social Participation was significantly predicted by UPSA total scores, controlling for age, education and severity of stroke. Regarding our sensitivity analysis, no differences were found between stroke survivors' and healthy controls' performance in UPSA total scores and domain scores, except in the transportation domain. The UPSA provides advantages for its use in this population including: the limited amount of training needed to administer and score it, its portability, and the time of administration (i.e., 30 minutes). In summary, findings from this study offer preliminary support for the feasibility, acceptability and validity of the UPSA as a performance-based measure of functional capacity in stroke survivors.