title: Modification of the upper limb functional index to a three-point response improves clinimetric properties.
abstract: METHODS
  Observational two-stage.
  
  
  BACKGROUND
  To achieve optimal clinimetric properties for outcome measures, both practical and psychometric, ongoing improvements are required.
  
  
  OBJECTIVE
  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.
  
  
  METHODS
  2c.
authors: Faculty of Science, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Queensland, Australia. Electronic address: cp.gabel@bigpond.com.
authors: Charles Philip
authors: CP
authors: Gabel
authors: Department of Physical Therapy, Virginia Commonwealth University, Virginia, USA.
authors: Lori A
authors: LA
authors: Michener
authors: Section of Medical and Surgical Sciences, Department of Orthopaedic Surgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
authors: Markus
authors: M
authors: Melloh
authors: Faculty of Science, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Queensland, Australia.
authors: Brendan
authors: B
authors: Burkett
mesh_terms: D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000503:physiopathology*; D011446:Prospective Studies; D011594:Psychometrics; D015203:Reproducibility of Results; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology*