Stroke Rehabilitation Assessment of Movement(STREAM)

Administration.

30 items observed and scored. Equipment minimal. Time ~15 minutes once familiar. Patient asked to perform each movement; rater scores quality and completion.

Scoring.

UE 0–20, LE 0–20, basic mobility 0–30. Item-level scoring 0–2 or 0–3.

Reliability and stroke-specific psychometrics.

• Interrater ICC for total score = 0.96; subscale ICCs 0.96–0.99 (Daley 1999).
• Test-retest reliability in chronic stroke: ICC 0.99 for total (Chen HM et al. *Arch Phys Med Rehabil*. 2007).
• A formal MCID for STREAM is not widely established; use MDC values from the reliability studies and pair with construct-specific measures (FMA, 10MWT, Berg).

What it measures.

Voluntary movement of the limbs and basic mobility post-stroke. Three subscales: UE (10 items × 0–2 = 20), LE (10 items × 0–2 = 20), basic mobility (10 items × 0–3, weighted ×2 = 30). Total 0–70 with subscale weighting.

History.

Daley K, Mayo N, Wood-Dauphinée S. *Phys Ther*. 1999;79:8–23. Developed at McGill University. Validity comparison with FIM and Stroke Impact Scale in Ahmed S, Mayo NE, Higgins J, Salbach NM, Finch L, Wood-Dauphinée SL. *Phys Ther*. 2003;83:617–630. A simplified version (S-STREAM) was published by Hsueh IP et al. *Phys Ther*. 2006;86:936–943, retaining concurrent validity.

When to use.

Acute through chronic stroke. Especially useful when the patient cannot tolerate walking-based measures but has motor and basic mobility goals.

When not to use.

When a stroke-specific UE measure with sensitivity to subtle changes is needed (use FMA-UE) or when a specific gait measure is needed (10MWT/6MWT).