Ecologically relevant outcome measure for post-inpatient rehabilitation

Carlos Marquez De La Plata, Devin Qualls, Patrick Plenger, James F. Malec, Mary Ellen Hayden

Research output: Contribution to journalArticle


BACKGROUND: Transfer of skills learned within the clinic environment to patients' home or community is important in post-inpatient brain injury rehabilitation (PBIR). Outcome measures used in PBIR assess level of independence during functional tasks; however, available functional instruments do not quantitate the environment in which the behaviors occur. OBJECTIVE: To examine the reliability and validity of an instrument used to assess patients' functional abilities while quantifying the amount of structure and distractions in the environment. METHODS: 2501 patients who sustained a traumatic brain injury (TBI) or cerebrovascular accident (CVA) and participated in a multidisciplinary PBIR program between 2006 and 2014 were identified retrospectively for this study. The PERPOS and MPAI-4 were used to assess functional abilities at admission and at discharge. Construct validity was assessed using a bivariate Spearman rho analysis A subsample of 56 consecutive admissions during 2014 were examined to determine inter-rater reliability. Intra-class correlation coefficient (ICC) and Kappa coefficients assessed inter-rater agreement of the total PERPOS and PERPOS subscales respectively. RESULTS: The PERPOS and MPAI-4 demonstrated a strong negative association among both TBI and CVA patients. Kappa scores for the three PERPOS scales each demonstrated good to excellent inter-rater agreement. The ICC for overall PERPOS scores fell in the good agreement range. CONCLUSION: The PERPOS can be used reliably in PBIR to quantify patients' functional abilities within the context of environmental demands.

Original languageEnglish (US)
Pages (from-to)187-194
Number of pages8
Issue number2
StatePublished - 2017


  • Brain Injury
  • CVA
  • environment
  • outcome measure
  • rehabilitation
  • TBI

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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  • Cite this

    Marquez De La Plata, C., Qualls, D., Plenger, P., Malec, J. F., & Hayden, M. E. (2017). Ecologically relevant outcome measure for post-inpatient rehabilitation. NeuroRehabilitation, 40(2), 187-194.