Charles Philip Gabel1, Lori A Michener2, Markus Melloh3, Brendan Burkett4. 1. Faculty of Science, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Queensland, Australia. Electronic address: cp.gabel@bigpond.com. 2. Department of Physical Therapy, Virginia Commonwealth University, Virginia, USA. 3. Section of Medical and Surgical Sciences, Department of Orthopaedic Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. 4. Faculty of Science, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Queensland, Australia.
Abstract
STUDY DESIGN: Observational two-stage. INTRODUCTION: To achieve optimal clinimetric properties for outcome measures, both practical and psychometric, ongoing improvements are required. PURPOSE OF THE STUDY: To evaluate if the Upper Limb Functional Index (ULFI) clinimetric properties are improved by modification to a three-point response option and to verify the factor structure. METHODS: Stage 1, calibration (n=139) used ULFI dichotomous responses, and stage 2, validation (n=117) used a three-point response option. The clinimetric properties were compared in physical therapy outpatients with the QuickDASH as the reference standard. Repeated measurements were made at two to four weekly intervals. RESULTS: The ULFI three-point response option improved reliability [intraclass correlation coefficient (2,1)=0.98], internal consistency (alpha=0.92), QuickDASH concurrent validity (r=0.86), and responsiveness. Minimal detectable change (90% confidence interval) was 7.9%, and factor structure was unidimensional. Missing responses were <0.5%, and practical characteristics were unchanged. CONCLUSIONS: The enhanced reliability and reduced errors with unchanged practicality demonstrate the ULFI improvements through modification to a three-point response option. LEVEL OF EVIDENCE: 2c. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.
STUDY DESIGN: Observational two-stage. INTRODUCTION: To achieve optimal clinimetric properties for outcome measures, both practical and psychometric, ongoing improvements are required. PURPOSE OF THE STUDY: To evaluate if the Upper Limb Functional Index (ULFI) clinimetric properties are improved by modification to a three-point response option and to verify the factor structure. METHODS: Stage 1, calibration (n=139) used ULFI dichotomous responses, and stage 2, validation (n=117) used a three-point response option. The clinimetric properties were compared in physical therapy outpatients with the QuickDASH as the reference standard. Repeated measurements were made at two to four weekly intervals. RESULTS: The ULFI three-point response option improved reliability [intraclass correlation coefficient (2,1)=0.98], internal consistency (alpha=0.92), QuickDASH concurrent validity (r=0.86), and responsiveness. Minimal detectable change (90% confidence interval) was 7.9%, and factor structure was unidimensional. Missing responses were <0.5%, and practical characteristics were unchanged. CONCLUSIONS: The enhanced reliability and reduced errors with unchanged practicality demonstrate the ULFI improvements through modification to a three-point response option. LEVEL OF EVIDENCE: 2c. Crown Copyright (c) 2010. Published by Elsevier Inc. All rights reserved.
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