Center for Smart Use of Technologies to Assess Real World Outcomes (C-STAR)
May 9–10
Live and Online
Offered by Academy, Shirley Ryan AbilityLab
The PRPS is a clinician-rated instrument designed to assess a patient's participation in therapy.
1
5 minutes
Per session
Adult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by the Rehabilitation Measures Team; Updated by Anna de Joya PT, MS, NCS and the TBI EDGE task force of the Neurology section of the APTA in 2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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TBI EDGE |
NR |
NR |
NR |
NR |
NR |
Recommendations for use based on ambulatory status after brain injury:
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Completely Independent |
Mildly dependant |
Moderately Dependant |
Severely Dependant |
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TBI EDGE |
N/A |
N/A |
N/A |
N/A |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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TBI EDGE |
No |
No |
No |
Not reported |
The PRPS does not assess different elements of participation and thus only provide a summary evaluation of each therapy session.
Assessments made by therapists between diagnostic groups may demonstrate some degree of differential validity. For example in one study evaluations made for stroke patients were more predictive our outcomes than for elective joint replacement (Lenze, 2004).
Only baseline disability (standardized β=.35, P=.02) and executive functions (standardized β=-40, P=.005) were significant predictors of rehabilitation participation, (F4,32=9.35; R2=.54, P=.001)(Skidmore et al., 2010)
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Acute In-Patient: (Lenze et al, 2004; n=242; diagnoses: elderly with neurologic, (eg, stroke), orthopedic (eg, fracture, joint replacement), or debility)
These cut offs were based on visual examination of the distribution and natural breaks in the data.
Acute Inpatients: (Lenze et al, 2004, n = 242; various diagnosis admitted for inpatient rehabilitation)
Acute Rehabilitation patients: ( Paolucci et al, 1012: n=348; mean age 59.41± 12.85, diagnoses: CVA, orthopedic , lower limb amputation.)
PRPS mean score
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Mean late score |
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CVA patients |
3.77±1.02 |
4.17±0.98 |
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Orthopedic patients |
4.17±0.86 |
4.30±0.89 |
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P value |
Z=3.92 P=0.000 |
Z=4.68 P=0.000 |
Acute Inpatients: (Lenze et al, 2004; Three occupational therapists and five physical therapists participated, 2 therapists independently rated each patient’s therapy session)
Acute Inpatients: (Lenze et al, 2004)
Acute Inpatients: (Lenze et al, 2004)
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PRPS Scores and Motor FIM Change in the 3 Impairment Subgroups |
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Group |
n |
PRPS Mean (SD) |
Motor FIM Change Mean (SD) |
Bivariate Correlation |
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Debility |
73 |
4.55 (0.70) |
20.3 (8.5) |
.34* |
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CVA |
38 |
4.62 (0.93) |
23.0 (10.4) |
.51† |
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Elective hip/knee |
56 |
4.96 (0.60) |
25.0 (6.4) |
.11 |
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Entire group |
242 |
4.73 (0.76) |
22.0 (8.8) |
.32† |
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*p = .01 |
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Stroke in Acute in-patient rehab: (Skidmore et al, 2010; n=44; mean age=73.6 (7.9); stroke onset, days=9.1(7.3))
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Measure |
PRPS (r) |
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Digit Span |
-.12 |
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HVLT |
.11 |
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Executive Interview |
-.55* |
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Hamilton Rating Scale for Depression |
-.39* |
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Apathy Evaluation Scale |
-.27 |
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FIM, baseline |
.56* |
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Time (days since stroke) |
-.30 |
*p <.01
To ensure the measure demonstrated adequate psychometric properties, developers conducted interviews with therapists as well as observed therapy sessions to better quantify different levels of participation
Community Dwelling Adults: (Talkowski et al, 2009; n = 18, participants all >60 years old; Longitudinal with three and six month follow-ups)
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Characteristics of Participants by Facility Type: |
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IRFs (n = 16) |
SNFs (n = 2) |
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Age in years (mean) |
78.0 |
86.0 |
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Minutes in therapy (mean) |
150.0 |
75.5 |
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Activity counts per minute (median) |
36.8 |
48.2 |
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PRPS scores (mean) |
5.0 |
5.2 |
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Baseline HFRS (mean) |
95.6 |
93.5 |
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IRF = Inpatient Rehabilitation Facilities |
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Hip Fracture: (Munin, 2005, n = 42 inpatient rehabilitation facilities, 34 = skilled nursing facilities; hip fracture patients undergoing rehabilitation, patients > 60 years old, had surgical stabilization of the fracture, and were living in the community when the fracture sustained)
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Baseline Demographics and Clinical Measures: |
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Inpatient rehabilitation facilities |
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Skilled nursing facilities |
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Demographics |
n |
mean (SD) |
min / max |
n |
mean (SD) |
min / max |
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Age (years) |
42 |
80.2 (8.4) |
61 / 94 |
34 |
83.9 (9.4) |
63 / 105 |
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Female (%) |
35 |
83.3 |
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27 |
79.4 |
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White (%) |
40 |
95.2 |
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30 |
88.2 |
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Social support |
41 |
18.5 (9.9) |
2 / 37 |
32 |
13.5 (6.9) |
1 / 31 |
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Cognitive measures |
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MMSE |
41 |
25.2 (3.8) |
16 / 30 |
34 |
23.0 (5.3) |
9 / 30 |
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HAMD |
41 |
9.5 (5.2) |
2 / 24 |
33 |
11.6 (5.9) |
4 / 26 |
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Delirium Rating Scale |
41 |
5.8 (5.7) |
2 / 24 |
33 |
8.3 (6.6) |
2 / 26 |
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Clinical measures |
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CIRS |
38 |
9.2 (3.1) |
3 / 18 |
31 |
10.2 (2.9) |
5 / 16 |
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Rehabilitation participation |
37 |
4.6 (0.8) |
2.1 / 6 |
22 |
4.3 (1.1) |
2.4 / 6 |
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Hospital LOS |
40 |
5.0 (1.9) |
2 / 12 |
31 |
6.4 (3.7) |
3 / 21 |
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Rehabilitation LOS |
36 |
12.8 (6.9) |
4 / 38 |
24 |
36.2 (20.5) |
15 / 90 |
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min / max = minimum and maximum scores
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Lenze, E. J., Munin, M. C., et al. (2004). "The Pittsburgh Rehabilitation Participation Scale: reliability and validity of a clinician-rated measure of participation in acute rehabilitation." Archives of physical medicine and rehabilitation 85(3): 380-384. Find it on PubMed
Munin, M. C., Seligman, K., et al. (2005). "Effect of rehabilitation site on functional recovery after hip fracture." Archives of physical medicine and rehabilitation 86(3): 367-372. Find it on PubMed
Paolucci, S., Di Vita, A., et al. (2012). "Impact of participation on rehabilitation results: a multivariate study." Eur J Phys Rehabil Med 48(3): 455-466. Find it on PubMed
Talkowski, J. B., Lenze, E. J., et al. (2009). "Patient participation and physical activity during rehabilitation and future functional outcomes in patients after hip fracture." Archives of physical medicine and rehabilitation 90(4): 618-622. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.