Programa de pós-graduação em Ciências da Reabilitação
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Master Thesis Confiabilidade intra e inter-examinador do mini-exame do estado mental para a população pós-acidente vascular cerebral(Universidade Federal do Rio Grande do Norte, 2024-09-30) Medeiros, Ana Loyse de Souza; Cacho, Roberta de Oliveira; https://orcid.org/0000-0002-0440-8594; http://lattes.cnpq.br/9802587696943482; http://lattes.cnpq.br/1465152528862285; Cacho, Enio Walker Azevedo; Alves, Marcus Vinicius Costa; Almeida, Kelson James Silva deIntroduction: Cognitive deficits are among the most impactful consequences of stroke, substantially diminishing the quality of life for those affected. The Mini-Mental State Examination (MMSE) is widely employed to screen cognitive status in post-stroke populations; however, psychometric data specific to the Brazilian-translated version in this group remain unavailable. Objective: This study aimed to evaluate the intra- and inter-examiner reliability of the MMSE for post-stroke individuals in Brazil. Methods: Thirty post-stroke participants were recruited via non-probabilistic sampling and assessed in-person using the MMSE by a trained examiner (E1). For inter-examiner reliability, two additional examiners (E2 and E3) independently scored the assessment via video recordings. To assess intra-examiner reliability, E1’s in-person scoring was compared to a second evaluation conducted by the same examiner through video 7 days later. Intraclass Correlation Coefficients (ICC) were used to analyze interand intra-examiner reliability, employing ICC2,1 and ICC3,1 models, respectively. Results: Excellent inter-examiner reliability was observed for the total MMSE score, with ICC values of 0.96 (E1 and E2), 0.98 (E1 and E3), and 0.97 (E2 and E3). Sub-item analysis indicated high reliability, except for visuospatial ability, classified as fair with ICC scores of 0.73 (E1 and E2) and 0.73 (E2 and E3). Intra-examiner reliability was also excellent, with an ICC of 0.99. Conclusion: The Brazilian MMSE version exhibited excellent inter- and intra-examiner reliability in the post-stroke population, except for the visuospatial ability sub-item. Caution is advised when administering this test to post-stroke patients, as careful adaptation may be required to accurately assess cognitive abilities.