A measure of physical functioning to define stroke recovery at 3 months: preliminary results.
OBJECTIVE
To develop a physical functioning measure through Rasch analysis conceptualized using the International Classification of Functioning, Disability and Health (ICF).


METHODS
Observational cohort study.


METHODS
Acute-hospital and community-based study.


METHODS
Subjects (N=235) hospitalized with postacute stroke and reassessed in the community at 3-months (mean age, 71.6+/-12.9 y).


METHODS
None.


METHODS
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.
Finch
Lois E
LE
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada. lois.finch@mail.mcgill.ca
Higgins
Johanne
J
Wood-Dauphinee
Sharon L
SL
Mayo
Nancy E
NE
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D020127:Recovery of Function; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology / Q000523:psychology; D000071939:Stroke Rehabilitation