The montréal rehabilitation performance profile: a statistical model for assessing stair descent in children with cognitive impairments 1  Lucie C Pelland, PhD, Patricia A McKinley, PhD  Archives of Physical Medicine and Rehabilitation  Volume 84, Issue 12, Pages 1813-1822 (December 2003) DOI: 10.1016/j.apmr.2003.03.008

Fig 1 The MRPP. To construct the surface plot of the MRPP, the value for each of the 4 variables is plotted on Cartesian axes as follows: MF on the right horizontal axis and logTR on the left horizontal axis, whereas PC is plotted on the upper vertical axis and ECtotal on the lower vertical axis. Three possible MRPP profiles are illustrated. (A) The lower limit MRPP profile is defined by a scalar along the TR axis (←) and represents the best possible stair descent performance in which only a rate of descent of less than 1s/step contributes to the PCS, which is calculated as PCS=−0(logTR)−(0.1MF+0PC+0ECtotal)=−0.1. (B) In contrast, the area for the upper limit MRPP profile is bordered by the dark diamond () and represents the least desirable stair descent performance with the consistent application of a tap-step pattern (MF=1), performed slowly (logTR>0), and with maximum reliance on proprioceptive (PC=1) and external cues (ECtotal=1.7) contributing to the PCS: PCS=−0.13(logTR)−(1.0MF+1.0PC+1.7ECtotal)=−3.83. (C) An intermediate MRPP profile (with its PCS) is illustrated, that is bordered by the light diamond (◊) and represents one of the transition profiles that is possible between the upper and lower MRPP limit profiles: PCS=−0(logTR)(1.0MF+0.5PC+0.5ECtotal)=−2. Archives of Physical Medicine and Rehabilitation 2003 84, 1813-1822DOI: (10.1016/j.apmr.2003.03.008)

Fig 2 The MRPP is plotted for 1 representative individual from the TS group at the 4 measurement intervals: T0, T10, PT5, and PT10. Conventions are as in figure 1 and the corresponding PCS is indicated in the upper right corner for each MRPP graph. (A) Preintervention (T0): for this child, the tap-step pattern was used exclusively (MF=1), performed slowly (TR=2s/step or logTR= .47) and with extensive reliance on perceptual (PC=0.5) and external (ECtotal=.67) cues: PCS=−2.47. (B) At the end of intervention (T10): an alternating pattern of descent was consistently used (MF=0), performed at the target rate of 1s/step (logTR=0), and with decreased reliance on perceptual cues (PC=0.2); reliance on external cues remained high (ECtotal=1): PCS=−1.20. (C, D) By PT5, the alternating pattern is consistently maintained, as at the end of the intervention, and PC and ECtotal have now been reduced to zero, with the TR showing further reduction at PT10: PCS=−.08 at PT5 and .08 at PT10. Archives of Physical Medicine and Rehabilitation 2003 84, 1813-1822DOI: (10.1016/j.apmr.2003.03.008)

Fig 3 The group mean (and 1 standard deviation) value for each of the 4 variables of the MRPP (, MF; •, logTR; ■, PC; ▴, ECtotal) is plotted at each of the 4 measurement times for (A) the TS and (B) the TNS group. The time-modulation for the individual components of ECtotal (•, tactile cues; , verbal cues; ▴, stabilizing cues) is shown in the insets for the TS and TNS groups. Archives of Physical Medicine and Rehabilitation 2003 84, 1813-1822DOI: (10.1016/j.apmr.2003.03.008)

Fig 4 The PCS score of all subjects is plotted along the abscissa, whereas the ordinal rating (from 1 to 10) obtained from the expert evaluation is plotted along the ordinate. On both the PCS and ordinal scales, performance improves as the values approach zero. The 2 sets of scores are related by a second-order regression line that accounted for 64% of the variance (R2=.64) between the scores. Archives of Physical Medicine and Rehabilitation 2003 84, 1813-1822DOI: (10.1016/j.apmr.2003.03.008)

Fig 5 Time-dependent change in unadjusted and adjusted PCS values. The mean group PCS scores are plotted for the TNS (■) and TS (▴) groups at the 4 measurement times in unadjusted (solid line) and adjusted (dotted line) form. Levels of significance for the change in PCS at T10, PT5, and PT10 relative to the baseline (T0) are indicated in table 2. Archives of Physical Medicine and Rehabilitation 2003 84, 1813-1822DOI: (10.1016/j.apmr.2003.03.008)