title: Can manual ability be measured with a generic ABILHAND scale? A cross-sectional study conducted on six diagnostic groups.
abstract: OBJECTIVE
  Several ABILHAND Rasch-built manual ability scales were previously developed for chronic stroke (CS), cerebral palsy (CP), rheumatoid arthritis (RA), systemic sclerosis (SSc) and neuromuscular disorders (NMD). The present study aimed to explore the applicability of a generic manual ability scale unbiased by diagnosis and to study the nature of manual ability across diagnoses.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Outpatient clinic homes (CS, CP, RA), specialised centres (CP), reference centres (CP, NMD) and university hospitals (SSc).
  
  
  METHODS
  762 patients from six diagnostic groups: 103 CS adults, 113 CP children, 112 RA adults, 156 SSc adults, 124 NMD children and 124 NMD adults.
  
  
  METHODS
  Manual ability as measured by the ABILHAND disease-specific questionnaires, diagnosis and nature (ie, uni-manual or bi-manual involvement and proximal or distal joints involvement) of the ABILHAND manual activities.
  
  
  RESULTS
  The difficulties of most manual activities were diagnosis dependent. A principal component analysis highlighted that 57% of the variance in the item difficulty between diagnoses was explained by the symmetric or asymmetric nature of the disorders. A generic scale was constructed, from a metric point of view, with 11 items sharing a common difficulty among diagnoses and 41 items displaying a category-specific location (asymmetric: CS, CP; and symmetric: RA, SSc, NMD). This generic scale showed that CP and NMD children had significantly less manual ability than RA patients, who had significantly less manual ability than CS, SSc and NMD adults. However, the generic scale was less discriminative and responsive to small deficits than disease-specific instruments.
  
  
  CONCLUSIONS
  Our finding that most of the manual item difficulties were disease-dependent emphasises the danger of using generic scales without prior investigation of item invariance across diagnostic groups. Nevertheless, a generic manual ability scale could be developed by adjusting and accounting for activities perceived differently in various disorders.
authors.affiliation: Physical and Occupational Therapy Departments, Paramedical Category,  Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre,  Belgium.
authors.forename: Carlyne
authors.initials: C
authors.lastname: Arnould
authors.forename: Laure
authors.initials: L
authors.lastname: Vandervelde
authors.forename: Charles Sèbiyo
authors.initials: CS
authors.lastname: Batcho
authors.forename: Massimo
authors.initials: M
authors.lastname: Penta
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Thonnard