[Show abstract][Hide abstract] ABSTRACT: A performance-based measure for assessing executive functions (EF) is useful to understand patients' real life performance of EF. This study aimed to develop a performance-based measure of executive functions (PEF) based on the Lezak model and to examine psychometric properties (i.e., unidimensionality and reliability) of the PEF using Rasch analysis in patients with schizophrenia. We developed the PEF in three phases: (1) designing the preliminary version of PEF; (2) consultation with experts, cognitive interviews with patients, and pilot tests on patients to revise the preliminary PEF; (3) establishment of the final version of the PEF and examination of unidimensionality and Rasch reliability. Two hundred patients were assessed using the revised PEF. After deleting items which did not satisfy the Rasch model's expectations, the final version of the PEF contained 1 practice item and 13 test items for assessing the four domains of EF (i.e., volition, planning, purposive action, and effective performance). For unidimensional and multidimensional Rasch analyses, the 4 domains showed good reliability (i.e., 0.77-0.85 and 0.87-0.90, respectively). Our results showed that the PEF had satisfactory unidimensionality and Rasch reliability. Therefore, clinicians and researchers could use the PEF to assess the four domains of EF in patients with schizophrenia.
PLoS ONE 11/2015; 10(11):e0142790. DOI:10.1371/journal.pone.0142790 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Prediction of voluntary upper extremity (UE) movement recovery is largely unknown in patients with little voluntary UE movement at admission. The present study aimed to investigate (1) the extent and variation of voluntary UE movement recovery, and (2) the best predictive model of the recovery of voluntary UE movement by clinical variables in patients with severe UE paresis.
Prospective cohort study.
140 (out of 590) stroke patients with severe UE paresis completed all assessments. Voluntary UE movement was assessed using the UE subscale of the Stroke Rehabilitation Assessment of Movement (STREAM-UE). Two outcome measures, STREAM-UE scores at discharge (DCSTREAM-UE) and changes between admission and discharge (ΔSTREAM-UE), were investigated to represent the final states and improvement of the recovery of voluntary UE movement. Stepwise regression analyses were used to investigate 19 clinical variables and to find the best predictive models of the two outcome measures.
The participants showed wide variation in both DCSTREAM-UE and ΔSTREAM-UE. 3.6% of the participants almost fully recovered at discharge (DCSTREAM-UE > 15). A large improvement (ΔSTREAM-UE >= 10) occurred in 16.4% of the participants, while 32.9% of the participants did not have any improvement. The four predictors for the DCSTREAM-UE (R2 = 35.0%) were 'baseline STREAM-UE score', 'hemorrhagic stroke', 'baseline National Institutes of Health Stroke Scale (NIHSS) score', and 'cortical lesion excluding primary motor cortex'. The three predictors for the ΔSTREAM-UE (R2 = 22.0%) were 'hemorrhagic stroke', 'baseline NIHSS score', and 'cortical lesion excluding primary motor cortex'.
Recovery of voluntary UE movement varied widely in patients with severe UE paresis after stroke. The predictive power of clinical variables was poor. Both results indicate the complex nature of voluntary UE movement recovery in patients with severe UE paresis after stroke.
PLoS ONE 05/2015; 10(5):e0126857. DOI:10.1371/journal.pone.0126857 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To examine the ecological validity, predictive validity, and responsiveness of the Five Digit Test (FDT) in patients with stroke.
We included inpatients with stroke (n = 144, 114 and 105 in the ecological validity, predictive validity, and responsiveness analysis, respectively) in the study. At admission, the FDT and Barthel Index (BI) were assessed; at discharge, the FDT, BI, Postural Assessment Scale for Stroke Patients (PASS), and Mobility Subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) were assessed.
In the ecological validity analysis, the scores of the selective and alternating attention indices of the FDT were moderately correlated with those of the BI at admission and discharge (Spearman ρ = -0.38 to -0.45). In the predictive validity analysis, the scores of the two attention indices of the FDT at admission were moderately correlated with the scores of the BI, PASS, and MO-STREAM at discharge (ρ = -0.33 to -0.45). In the responsiveness analysis, the two attention indices of the FDT between admission and discharge had large differences (success rate difference = 0.56-0.67, Wilcoxon Z = -5.90 to -6.60).
Our results indicate that the selective and alternating attention indices of the FDT have acceptable ecological validity, predictive validity, and good responsiveness in patients with stroke. Implications for Rehabilitation The Five Digit Test (FDT), an efficient and culture-free assessment tool, has been used to assess selective attention and alternating attention The selective index and alternating attention index of the FDT showed acceptable ecological validity, predictive validity, and good responsiveness in patients with stroke.
Disability and Rehabilitation 04/2015; DOI:10.3109/09638288.2015.1031288 · 1.99 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives: To develop a computerized Digit Vigilance Test (C-DVT) with lower random measurement error than that of the DVT and to examine the concurrent validity, ecological validity, and test-retest reliability of the C-DVT in patients with stroke. Design: A cross-sectional study. Patients: Forty-four patients with stroke. Methods: We developed and tested the C-DVT. To examine the psychometric properties, the participants completed both the C-DVT and DVT twice with a 14-day interval. Results: We developed the C-DVT on the basis of expert input and examinee feedback. C-DVT scores were highly correlated with DVT scores (ρ = 0.75), supporting the concurrent validity. The C-DVT scores were moderately correlated with the scores of the Barthel Index and the Activities of Daily Living Computerized Adaptive Testing system (ρ = -0.60~-0.57), supporting the ecological validity. The test-retest agreement of the C-DVT was excellent (intra-class correlation coefficient = 0.92). The random measurement error of the C-DVT (minimal detectable change percent change (MDC%) = 15.4%) was acceptable and lower than that of the DVT (33.0%). The practice effects of the C-DVT were statistically significant, but the effect size d was small (0.15). Conclusion: A C-DVT with a limited amount of random measurement error was developed. These preliminary findings show that the C-DVT demonstrates satisfactory concurrent validity, ecological validity, and test-retest reliability in patients with stroke.
Journal of Rehabilitation Medicine 02/2015; 47(4). DOI:10.2340/16501977-1945 · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
The Barthel Index (BI) assesses actual performance of activities of daily living (ADL). However, comprehensive assessment of ADL functions should include two other constructs: self-perceived difficulty and ability.
The aims of this study were to develop two BI-based Supplementary Scales (BI-SS), namely, the Self-perceived Difficulty Scale and the Ability Scale, and to examine the construct validity of the BI-SS in patients with stroke.
The BI-SS was first developed by consultation with experts and then tested on patients to confirm the clarity and feasibility of administration. A total of 306 participants participated in the construct validity study. Construct validity was investigated using Mokken scale analysis and analyzing associations between scales. The agreement between each pair of the scales’ scores was further examined.
The Self-perceived Difficulty Scale consisted of 10 items, and the Ability Scale included 8 items (excluding both bladder and bowel control items). Items in each individual scale were unidimensional (H≥0.5). The scores of the Self-perceived Difficulty and Ability Scales were highly correlated with those of the BI (rho = 0.78 and 0.90, respectively). The scores of the two BI-SS scales and BI were significantly different from each other (p<.001). These results indicate that both BI-SS scales assessed unique constructs.
The BI-SS had overall good construct validity in patients with stroke. The BI-SS can be used as supplementary scales for the BI to comprehensively assess patients’ ADL functions in order to identify patients’ difficulties in performing ADL tasks, plan intervention strategies, and assess outcomes.
PLoS ONE 10/2014; 9(10):e110494. DOI:10.1371/journal.pone.0110494 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Abstract Objectives: To investigate practice effect and test-re-test reliability of the Five Digit Test (FDT) over four serial assessments in patients with stroke. Design: Single-group repeated measures design. Methods: Twenty-five patients with stroke were administered the FDT in four consecutive assessments every 2 weeks. The FDT contains four parts with five indices: 'basic measures of attention and processing speed', 'selective attention', 'alternating attention', 'ability of inhibition' and 'ability of switching'. Results: The five indices of the FDT showed trivial-to-small practice effects (Cohen's d = 0.03-0.47) and moderate-to-excellent test-re-test reliability (intra-class correlation coefficient = 0.59-0.97). Practice effects of the five indices all appeared cumulative, but one index, 'basic measures of attention and processing speed', reached a plateau after the second assessment. The minimum and maximum values of the 90% confidence interval (CI) of reliable change index modified for practice (RCIp) for this index were [-17.6, 11.2]. Conclusions: One of five indices of the FDT reached a plateau, whose minimum and maximum values of the 90% CI RCIp are useful to determine whether the change in an individual's score is real. However, clinicians and researchers should be cautious when interpreting the test results of these four indices over repeated assessments.
[Show abstract][Hide abstract] ABSTRACT: Objective: To examine the intrarater reliability, interrater reliability, and responsiveness of the Activities of Daily Living Computerized Adaptive Testing system (ADL CAT) in patients with stroke. Design: One repeated-measures design (at an interval of 7d) was used to examine the intrarater reliability and interrater reliability of the ADL CAT. For the responsiveness study, participants were assessed with the ADL CAT at admission to the rehabilitation ward and at discharge from the hospital. Setting: Eight rehabilitation units. Participants: Three different (nonoverlapping) groups of patients (N=157) were recruited. Fifty-five and 42 outpatients with chronic stroke participated in the intrarater and interrater reliability studies, respectively; 60 inpatients who had recently had a stroke participated in the responsiveness study. Interventions: Not applicable. Main Outcome Measure: ADL CAT. Results: The intraclass correlation coefficient values were .94 and .80 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The classical test theory based minimal detectable change values were 6.5 and 9.5 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The Kazis' effect size and standardized response mean of the ADL CAT were moderate (.62-.73). Conclusions: The ADL CAT has good intrarater reliability and interrater reliability in outpatients with chronic stroke, and sufficient responsiveness in inpatients with stroke undergoing inpatient rehabilitation. Further investigations on the responsiveness of the ADL CAT in outpatients are needed to obtain more evidence on the utility of the ADL CAT. (C) 2014 by the American Congress of Rehabilitation Medicine
Archives of Physical Medicine and Rehabilitation 05/2014; 95(11). DOI:10.1016/j.apmr.2014.04.025 · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background/Purpose
Health-related quality of life (HRQOL) is considered an important outcome indicator in substances abuse studies. However, psychometric properties of HRQOL measures are largely unknown in people who abuse heroin. Therefore, the present study aimed to examine data quality, scaling properties, reliability, and construct validity of the 36-Item Short Form healthy survey (SF-36) in people who abuse heroin.
A total of 469 people who abuse heroin participated in the study. Data quality was determined by data completeness. Scaling properties were evaluated by item frequency distribution, equivalence of item means and standard deviations, item-internal consistency, and item-discriminant validity (calculating scaling success). Internal consistency was examined using Cronbach's α. Construct validity was examined by investigating convergent validity and divergent validity among the eight scales of the SF-36.
The results of data quality showed low missing rates (0.0–3.8%) and high completion rates in the scales (91.9–98.7%). The results of scaling assumptions showed good item frequency distribution on each item, roughly equivalent item means and standard deviations within a scale, good item-internal consistency (>0.4) and good scaling success rates (77.5–100%), except on the two scales of bodily pain (BP) and social functioning (SF). Three scales showed ceiling and/or floor effects [i.e., physical functioning (PF), role limitations due to physical problems (RP), and role limitations due to emotional problems (RE)]. Cronbach's α was acceptable (>0.7), except for the BP and SF scales. Construct validity was partially supported by the results of convergent validity and divergent validity.
The results confirmed good data quality; satisfactory scaling assumptions and internal consistency (except for the BP and SF scales); and generally acceptable construct validity. However, the PF, RP, and RE scales showed ceiling and/or floor effects. Therefore, the BP, SF, PF, RP, and RE scales should be used with cautions in measuring HRQOL in people who abuse heroin.
Journal of the Formosan Medical Association 04/2014; 113(4):234–241. DOI:10.1016/j.jfma.2012.05.010 · 1.97 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective:
To examine the measurement properties of Test of Everyday Attention (TEA) in patients with chronic stroke including: test-retest reliability between parallel forms (i.e. forms AB, BC and CA), practice effect and critical values for detecting true change corrected for practice effect and measurement error.
Ninety patients with chronic stroke (months since onset > 6) were randomly assigned to receive forms AB, BC or CA of the TEA in a counterbalanced order. A test-retest design was used with a 1-week interval.
All TEA sub-tests had good-to-excellent test-retest reliability among the three parallel forms except the Telephone Search While Counting (ICC = 0.51-0.59). Small practice effects were observed for almost all sub-tests. The reliable change index corrected for practice effect (RCIp) was provided for each sub-test.
Most TEA sub-tests show promise as reliable measures of attention for repeated use with the parallel forms in patients with chronic stroke. Practice effects must be considered to interpret an individual change in clinical settings. Therefore, the value of RCIp provides a conservative estimate of a patient's progress, representing the smallest change in the TEA score that could be interpreted as true change, corrected for practice effects and measurement error.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: The group-level responsiveness of the Postural Assessment Scale for Stroke Patients (PASS) is similar to that of the short form PASS (SFPASS). This result is counterintuitive because the PASS has more items (12) and response levels (4) than does the SFPASS (5 items and 3 response levels). OBJECTIVE: To compare individual-level responsiveness between both measures to determine whether the SFPASS can detect change as sensitively as the PASS. STUDY DESIGN AND SETTING: 251 patients were assessed using the PASS at 14 and 30 days after stroke onset in a medical center. METHODS: The SFPASS scores were calculated from the patients' responses on the PASS. We calculated individual-level responsiveness on the basis of the value of minimal detectable change (MDC). If a patient's change score was greater than the MDC of the PASS or SFPASS, his/her improvement was considered significant. We examined the difference of the number of patients scoring greater than the MDC and the units of MDC (the MDC ratio) improved by the patients on both measures. RESULTS: 53.0% of the patients scored greater than the MDC of the PASS, while 43.0% of the patients scored greater than the MDC of the SFPASS. The difference was significant. The mean MDC ratio of the PASS (1.8±1.7) was significantly higher than that of the SFPASS (1.2±1.3). LIMITATIONS: The scores of the SFPASS were retrieved from those of the PASS, which limits the generalization of our findings. CONCLUSION: The PASS has better individual-level responsiveness than does the SFPASS. To comprehensively report effects of clinical trials, future studies using the PASS should report the individual-level effect (e.g., number of patients scoring greater than the MDC).
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: The responsiveness and predictive validity of the Hierarchical Balance Short Forms (HBSF) in patients with stroke is unknown, which limits the HBSF's utility in both clinical and research settings. OBJECTIVE: The purpose of this study was to investigate the responsiveness and predictive validity of the HBSF in inpatients with stroke receiving rehabilitation. DESIGN: A prospective cohort study was conducted. METHOD: Sixty-six participants completed both the 6-item HBSF and the 12-item Postural Assessment Scale for Stroke patients (PASS) after admission to the rehabilitation ward and before hospital discharge. Effect size (ES) and standardized response mean (SRM) were used to investigate the internal responsiveness of the HBSF and PASS. The changes in the Barthel Index (BI) and the mobility subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) were used as the external criteria for examining external responsiveness. Moreover, the admission scores of the HBSF and PASS and the discharge scores of the BI and MO-STREAM were analyzed to investigate the predictive validity of the two balance measures. RESULTS: The internal responsiveness of the HBSF was high (ES>0.9; SRM>1.6). The SRM of the HBSF was significantly larger than that of the PASS, whereas the ES of the HBSF was not significantly larger than that of the PASS. The external responsiveness and predictive validity of the HBSF were sufficient and similar to those of the PASS (external responsiveness: r≧0.35; predictive validity: r≧0.67). LIMITATIONS: The convenience sampling of inpatients with stroke may limit the generalization of the results. CONCLUSIONS: The HBSF has sufficient responsiveness and predictive validity in inpatients with stroke receiving rehabilitation and is thus recommended for both clinicians and researchers.
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. OBJECTIVE: To construct a computerized adaptive testing (CAT) system for measuring ADL function for outpatients with stroke. STUDY DESIGN AND SETTING: Two cohort studies at six hospitals in Taiwan. METHODS: We developed a candidate item bank (44 items) and interviewed 643 outpatients. Then we fitted an item response theory model to the data and estimated the item parameters (e.g., difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. OUTCOME MEASURES: The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. RESULTS: Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. We set 2 stopping rules (i.e., reliability coefficient >0.9 or =7 items) for the CAT. The patients' ADL scores had an average reliability of 0.93. The CAT scores were highly associated with those of the full 34 items (Pearson's r=0.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=0.82). The time required to complete the CAT was about 1/5 of the time used to administer both the BI and FAI together. LIMITATIONS: The participants were outpatients living in the community. Further studies are needed to cross-validate the results. CONCLUSIONS: Our results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.
[Show abstract][Hide abstract] ABSTRACT: To examine the test-retest reliability, convergent validity, and predictive validity of the comprehensive activities of daily living (CADL) measure in patients with stroke.
A repeated-assessments design, 10-14 days apart, was used to examine test-retest reliability in 70 patients. In the validity study, a further 168 patients were assessed at 6 months and 1 year after stroke.
Three rehabilitation units.
The CADL measure, providing Rasch-calibrated scores, assesses the entire continuum of basic and instrumental activities of daily living. Both domains (self-care and mobility) of the stroke-specific quality of life questionnaire (SS-QOL) were used to examine the convergent validity. The summary score of the SS-QOL was used as the criterion for examining the predictive validity of the CADL measure.
The test-retest reliability was excellent (intraclass correlation coefficient = 0.96). The CADL measure and both domains of the SS-QOL exhibited strong associations at 6 months and 1 year post-stroke (Pearson's r ≥ 0.77). The score of the CADL at 6 months post-stroke was highly correlated with that of the SS-QOL at 1 year post-stroke (r = 0.75).
The CADL measure showed satisfactory test-retest reliability, convergent validity, and predictive validity in patients with stroke.
Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 06/2012; 44(8):637-41. DOI:10.2340/16501977-1004 · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To develop a computerized adaptive testing system of the Fugl-Meyer motor scale (CAT-FM) to efficiently and reliably assess motor function in patients with stroke.
First, a simulation study was used to develop and examine the psychometric properties of the CAT-FM. Second, a field study was employed to determine the administration efficiency of the CAT-FM.
One medical center and 1 teaching hospital.
Patients' responses (n=301) were used for the simulation study; 49 patients participated in the field study.
The 2 CAT-FM item banks (upper extremity and lower extremity) include 37 items from the original Fugl-Meyer scale. The reliability, validity, and responsiveness of the CAT-FM were determined by the simulation study.
Two stopping rules (reliability ≥0.9 or an increase of reliability <.01 after testing an item) were used. The simulation study showed that the CAT-FM had high reliability (≥.93 for upper-extremity and lower-extremity subscales) and concurrent validity (Pearson r≥.91 for the upper-extremity and lower-extremity subscales and motor scale). The responsiveness was moderate (standardized response mean for the upper extremity=.67, lower extremity=.79, and motor=.77) for the 226 patients who completed both assessments at 14 and 90 days after stroke. The field study found that, on average, the time needed to administer the CAT-FM was 242 seconds with 4.7 items.
The CAT-FM is an efficient, reliable, valid, and responsive clinical tool for assessing motor function in patients with stroke.
Archives of physical medicine and rehabilitation 03/2012; 93(6):1014-20. DOI:10.1016/j.apmr.2011.12.005 · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Patient perceived health care quality is a key indicator of health service quality. However, so far in Taiwan, no measure assesses the health care quality of Occupational Therapy services, leading serious impact on the promotion of occupational therapy quality. The purpose of the present study was to elaborate a generic methodology for developing the domains and items of Patient’s Review on Occupational Therapy for Stroke patients questionnaire (PROTS) for further psychometric testing. The procedure included 3 steps: (a) reviewing related literature and carrying out clinical interviews to develop preliminary domains and items; (b) consulting with the expert group to establish content validity of the PROTS; (c) conducting cognitive interviews with stroke patients or their main caregivers to establish the face validity of the PROTS. Finally, the PROTS pre-testing version was consisted of 102 items for 8 domains: Staff ’s attitude (14 items), Staff ’s ability (31 items), Information (8 items), Consistency of care (13 items), Timely care (9 items), Psychosocial support (6 items), Environment (11 items), and Discharge prepare/Home care guidance (10 items). The PROTS will be applied in further survey to establish its reliability and construct validity. The PROTS can be used to improve the health care quality of occupational therapy.
[Show abstract][Hide abstract] ABSTRACT: To compare the responsiveness and predictive validity of the Balance Computerized Adaptive Test (Balance CAT) and the Postural Assessment Scale for Stroke patients (PASS) in inpatients with stroke receiving rehabilitation.
A pre-post test design.
Eighty-five inpatients after stroke.
Effect size d and Wilcoxon signed-rank test were used to assess the internal responsiveness of the Balance CAT and PASS. The changes in the Barthel Index (BI) and the mobility subscale of the Stroke Rehabilitation Assessment of Movement (MO-STREAM) scores were both chosen as the external criteria for examining external responsiveness. Moreover, to investigate the predictive validity, the admission scores of the two balance measures, and the discharge score of the BI/MO-STREAM, were examined by simple linear regression analysis.
Both the Balance CAT and PASS had high internal responsiveness (effect size d ≥ 0.87) and fair external responsiveness (r(2) ≥ 0.20). The predictive validities of both measures were sufficient (r(2) ≥ 0.33). The Balance CAT took approximately 3 items (min-max = 2-4) to complete.
The Balance CAT and PASS have sufficient responsiveness and predictive validity in inpatients with stroke receiving rehabilitation. The Balance CAT is more efficient to administer and is thus recommended over the PASS.
Journal of rehabilitation medicine: official journal of the UEMS European Board of Physical and Rehabilitation Medicine 11/2011; 44(2):176-80. DOI:10.2340/16501977-0903 · 1.68 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To investigate the construct validity of the commonly used 8- and 12-domain versions of the Stroke-Specific Quality of Life (SS-QOL) with a first-order factor model. The better-fitted version was further evaluated by a second-order factor structure model in order to determine whether a summary score is justified.
Outpatient stroke clinic.
Patients (N=388) with ischemic stroke.
The SS-QOL. We first conducted confirmatory factor analysis (CFA) to evaluate the construct validity of the first-order 8- or 12-domain versions of the SS-QOL. The better-fitted version was then validated by investigating the second-order health-related quality of life (HRQOL) factor.
The 12-domain version, but not the 8-domain version, had sufficient goodness of fit (χ(2)=2041.7, df=1061, χ(2)/df=1.9, comparative fit index [CFI]=0.98, Tucker-Lewis index [TLI]=0.98, and root mean square error of approximation=0.05). All items of the 12-domain version showed acceptable factor loadings (>0.40) and were retained. Furthermore, the second-order CFA fit indices of the 12 domains were acceptable (χ(2)=2630.3, df=1115, χ(2)/df=2.4, CFI=0.97, TLI=0.97, root mean square error of approximation=0.06), indicating that a summary score was justified for representing the overall status of HRQOL.
Our results show that the construct validity of the 12-domain SS-QOL is well supported for measuring HRQOL in ischemic stroke patients. Thus, we recommend the 12-domain version of the SS-QOL for use in capturing the multiple impacts of stroke as well as overall HRQOL status on the basis of patients' perspectives.
Archives of physical medicine and rehabilitation 07/2011; 92(7):1113-8. DOI:10.1016/j.apmr.2011.02.008 · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To develop a set of 3 hierarchical balance short forms (HBSF; containing sitting, standing, and stepping forms) to measure balance function in patients with stroke.
First, we developed the HBSF, based on a previous data set, with each short form containing 6 items. Second, we examined the psychometric properties and efficiency of the HBSF.
Six teaching hospitals.
Patients with stroke (n=764) for the first part of this study; inpatients and outpatients (n=85) for the second part of this study.
We used the item bank (9 sitting-related, 14 standing-related, and 13 stepping-related items) from the Balance Computerized Adaptive Test to develop the HBSF. Both the HBSF and the Berg Balance Scale (BBS) were administered to patients, to determine the concurrent validity and time needed for administration of both measures. Each patient was assessed by 1 of the 3 short forms selected by a rater.
The reliability of the HBSF was relatively high (reliability coefficients, .94-.95). The scores of the HBSF were highly correlated with those of the BBS (Spearman ρ=.80-.91), supporting the concurrent validity of the HBSF. The average time needed to administer the HBSF was 122 seconds (ie, about 40% of that for the BBS).
Our results provide sufficient evidence that the HBSF is an efficient, reliable, valid, and practical way to measure balance function in patients with stroke.
Archives of physical medicine and rehabilitation 07/2011; 92(7):1119-25. DOI:10.1016/j.apmr.2011.02.012 · 2.57 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The Symbol Digit Modalities Test (SDMT) is commonly used to evaluate an individual's switching attention and processing speed. However, its test-retest reliability and practice effect are not well known in patients with stroke, limiting its utility in both clinical and research settings. The present study examined the two aforementioned psychometric properties of the oral-format SDMT on a group of 30 outpatients with stroke. The oral-format SDMT demonstrated excellent test-retest reliability (ICC = 0.89) and a small practice effect (Cohen's d = 0.26) within a 1-week interval. A practice effect-corrected reliable change index [-5.29, 10.89] was also provided to help clinicians and researchers interpret their clients' test results. Patients' characteristics and the test-retest interval should be considered before applying the findings of the present study to clinical settings.