The Pittsburgh rehabilitation participation scale: Reliability and validity of a clinician-rated measure of participation in acute rehabilitation

Objective: To demonstrate interrater reliability and predictive validity of the Pittsburgh Rehabilitation Participation Scale (PRPS), a clinician-rated 6-point Likert-type item measuring patient participation in inpatient rehabilitation sessions. Design: Prospective measurement of patient participation in physical and occupational therapy sessions during inpatient rehabilitation. Setting: University-based, freestanding acute rehabilitation hospital. Participants: Two hundred forty-two inpatients, primarily elderly, with a variety of impairment diagnoses (eg, stroke), who were admitted for inpatient rehabilitation. Interventions: Not applicable. Main Outcome Measures: Change in the 13 motor items from the FIM(TM) instrument, from admission to discharge. Results: The PRPS had high interrater reliability (intraclass correlation coefficient [ICC]=.91 for occupational therapists; ICC=.96 for physical therapists). The subjects had mean PRPS scores +/- standard deviation of 4.73+/-0.76. Mean PRPS scores predicted rehabilitation outcome (N=242, r=.32, P<.0001), as measured by change in motor FIM. The strength of this association did not change in a multivariate model that controlled for age, gender, race, impairment group, medical co-morbidity count, length of stay, and admission FIM. Conclusions: Patient participation during acute inpatient rehabilitation can be easily and reliably measured, and PRPS scores predict functional outcome. The PRPS may have applicability in clinical and research outcome measurement.