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RehabMeasures Instrument

Supervision Rating Scale

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Purpose

The SRS describes amount and type of supervision and frequency of monitoring received by an individual following TBI.

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Instrument Details

Acronym SRS

Cost

Free

Diagnosis/Conditions

  • Brain Injury Recovery

Populations

Key Descriptions

  • The SRS is a 13-point ordinal scale of ranked levels of supervision.
  • The items on the scale can also be grouped in 5 broader categories:
    1) Independent (2 levels)
    2) Overnight supervision (1 level)
    3) Part-time supervision (4 levels)
    4) Full-time indirect supervision (2 levels)
    5) Full-time direct supervision (4 levels)
  • Ratings on the 13-point scale automatically categorize a patient into one of the 5 supervision levels, although users can bypass the 13-point scale and classify a patient directly into one of the 5 levels.

Number of Items

1 item
13 rating levels

Time to Administer

Less than 5 minutes

Required Training

No Training

Instrument Reviewers

Initially reviewed by Karen McCulloch, PT, PhD, NCS and the TBI taskforce of the Neurology Section of the APTA in 6/2012.

ICF Domain

Participation

Professional Association Recommendation

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:  

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

TBI EDGE

NR

NR

NR

NR

NR

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

 

Recommendations for entry-level physical therapy education and use in research:

 

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)

TBI EDGE

No

No

No

Not reported

Considerations

  • Support for this scale is based on a single article and has not been widely studied.

  • 5 level SRS may be more useful than 13 point SRS because of advantages in communication with non specialists (Boake, 1996)

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Brain Injury

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Interrater/Intrarater Reliability

Traumatic Brian Injury: (Boake 1996; a subsample of 19 patients from a larger pool of 114 of individuals with moderate to severe TBI who were living in the community, on average were 3.8 years post injury)

  • Excellent interrater reliability (ICC for 13 level SRS was .86)
  • Weighted K for 5 level categories was .64 with 74% agreement

Construct Validity

Traumatic Brain Injury: (Boake 1996)

  • Excellent correlation of SRS with GOS (K-tau=.73) and DRS (k-tau=.65) reflecting expected associations with measures of global outcome

Bibliography

Boake, C. (1996). "Supervision rating scale: a measure of functional outcome from brain injury." Arch Phys Med Rehabil 77(8): 765-772.