title: Issues for selection of outcome measures in stroke rehabilitation: ICF Participation.
abstract: OBJECTIVE
  To evaluate the psychometric and administrative properties of outcome measures in the ICF Participation category, which are used in stroke rehabilitation research and reported in the published literature.
  
  
  METHODS
  Critical review and synthesis of measurement properties for six commonly reported instruments in the stroke rehabilitation literature. Each instrument was rated using the eight evaluation criteria proposed by the UK Health Technology Assessment (HTA) programme. The instruments were also assessed for the rigour with which their reliability, validity and responsiveness were reported in the published literature.
  
  
  RESULTS
  Validity has been well reported for at least half of the measures reviewed. However, methods for reporting specific measurement qualities of outcome instruments were inconsistent. Responsiveness of measures has not been well documented. Of the three ICF categories, Participation seems to be most problematic with respect to: (a) lack of consensus on the range of domains required for measurement in stroke; (b) much greater emphasis on health-related quality of life, relative to subjective quality of life in general; (c) the inclusion of a mixture of measurements from all three ICF categories.
  
  
  CONCLUSIONS
  The reader is encouraged to examine carefully the nature and scope of outcome measurement used in reporting the strength of evidence for improved participation associated with stroke rehabilitation. There is no consensus regarding the most important indicators of successful involvement in a life situation and which ones best represent the societal perspective of functioning. In particular, quality of life outcomes lack adequate conceptual frameworks to guide the process of development and validation of measures.
authors.affiliation: Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care London, London, Ontario, Canada. Katherine.Salter@sjhc.london.on.ca
authors.forename: K
authors.initials: K
authors.lastname: Salter
authors.forename: J W
authors.initials: JW
authors.lastname: Jutai
authors.forename: R
authors.initials: R
authors.lastname: Teasell
authors.forename: N C
authors.initials: NC
authors.lastname: Foley
authors.forename: J
authors.initials: J
authors.lastname: Bitensky
authors.forename: M
authors.initials: M
authors.lastname: Bayley
mesh_terms: D000203:Activities of Daily Living; D006305:Health Status Indicators; D006801:Humans; D017063:Outcome Assessment, Health Care; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D000071939:Stroke Rehabilitation