OBJECTIVE: To develop a physical functioning measure through Rasch analysis conceptualized using the International Classification of Functioning, Disability and Health (ICF). DESIGN: Observational cohort study. SETTING: Acute-hospital and community-based study. PARTICIPANTS: Subjects (N=235) hospitalized with postacute stroke and reassessed in the community at 3-months (mean age, 71.6+/-12.9 y). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Functional assessments 3 months poststroke included self-report and observational indices and tests commonly used to evaluate stroke survivors. Sociodemographic information was also collected. Rasch analysis assisted in combining the items across ICF components to develop the measure. Items were retained based on fit to the model and relationship to the construct; reliability and validity were assessed. RESULTS: The best 44 items formed the Physical Functioning Measure at 3 months (F3m) measure of functioning evaluating limb movement, balance, activities of daily living, and participation. All Rasch model assumptions were met. Both item and person reliably (.96) indicated a stable hierarchy, while precision varied from .51 to 1.2 logits. Early evidence for construct validity is adequate. CONCLUSIONS: The F3m combines patient reported and observed ratings of performance items into a single measure quantifying functioning with good preliminary psychometric properties that with further testing can assist in directing and evaluating interventions and recovery.
OBJECTIVE: To develop a physical functioning measure through Rasch analysis conceptualized using the International Classification of Functioning, Disability and Health (ICF). DESIGN: Observational cohort study. SETTING: Acute-hospital and community-based study. PARTICIPANTS: Subjects (N=235) hospitalized with postacute stroke and reassessed in the community at 3-months (mean age, 71.6+/-12.9 y). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Functional assessments 3 months poststroke included self-report and observational indices and tests commonly used to evaluate stroke survivors. Sociodemographic information was also collected. Rasch analysis assisted in combining the items across ICF components to develop the measure. Items were retained based on fit to the model and relationship to the construct; reliability and validity were assessed. RESULTS: The best 44 items formed the Physical Functioning Measure at 3 months (F3m) measure of functioning evaluating limb movement, balance, activities of daily living, and participation. All Rasch model assumptions were met. Both item and person reliably (.96) indicated a stable hierarchy, while precision varied from .51 to 1.2 logits. Early evidence for construct validity is adequate. CONCLUSIONS: The F3m combines patient reported and observed ratings of performance items into a single measure quantifying functioning with good preliminary psychometric properties that with further testing can assist in directing and evaluating interventions and recovery.
Authors: Barbara Resnick; Ann L Gruber-Baldini; Gregory Hicks; Glen Ostir; N Jennifer Klinedinst; Denise Orwig; Jay Magaziner Journal: Rehabil Nurs Date: 2015-10-23 Impact factor: 1.625