title: Improvement of the Van Lieshout hand function test for tetraplegia using a Rasch analysis.
abstract: METHODS
  Cross-sectional study.
  
  
  OBJECTIVE
  The Van Lieshout hand function test for tetraplegia (VLT) measures the quality of arm-hand functioning in persons with tetraplegia. It is valid, reliable and responsive. However, it does not satisfy all the criteria for interval level measurement. The present study aims to apply the Rasch model to the VLT short form (VLT-SF) to upgrade its scale type towards interval level, and to verify if the requirements of an objective measure are satisfied in the revised version.
  
  
  METHODS
  Eight Dutch Rehabilitation centres.
  
  
  METHODS
  The VLT-SF data of 73 tetraplegic patients were Rasch-analysed (RUMM2030 software, RUMM Laboratory Pty Ltd, Perth, Australia) to verify the order of response categories, unidimensionality and reliability of the VLT-SF, and to assess its applicability regardless of (motor) lesion completeness.
  
  
  RESULTS
  Seven of the ten VLT-SF items showed disordered response categories. The six original response categories were therefore recoded into three or four categories. After recoding, all items satisfied the model requirement of unidimensionality. The items were relatively well-targeted on the subjects' arm-hand skilled performance measures, leading to a good person separation index (R=0.91). The difficulty hierarchy of the VLT-SF items was invariant across patient subgroups of (motor) lesion completeness.
  
  
  CONCLUSIONS
  Provided that response categories are recoded, VLT-SF Rasch analysis showed that the requirements of an objective measure were satisfied. This allows to compare the measurements of different patients quantitatively, and to follow their results over time.
authors.affiliation: 1] Rehabilitation Sciences, Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands [2] Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.
authors.forename: A I F
authors.initials: AI
authors.lastname: Spooren
authors.forename: C
authors.initials: C
authors.lastname: Arnould
authors.forename: R J E M
authors.initials: RJ
authors.lastname: Smeets
authors.forename: H M H
authors.initials: HM
authors.lastname: Bongers
authors.forename: H A M
authors.initials: HA
authors.lastname: Seelen
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies / Q000379:methods; D004185:Disability Evaluation; D005260:Female; D006225:Hand / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology* / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D013223:Statistics as Topic / Q000379:methods; D055815:Young Adult