Reliability and responsiveness of the activities of daily living computerized adaptive testing system in patients with stroke.
OBJECTIVE
To examine the intrarater reliability, interrater reliability, and responsiveness of the Activities of Daily Living Computerized Adaptive Testing system (ADL CAT) in patients with stroke.


METHODS
One repeated-measures design (at an interval of 7d) was used to examine the intrarater reliability and interrater reliability of the ADL CAT. For the responsiveness study, participants were assessed with the ADL CAT at admission to the rehabilitation ward and at discharge from the hospital.


METHODS
Eight rehabilitation units.


METHODS
Three different (nonoverlapping) groups of patients (N=157) were recruited. Fifty-five and 42 outpatients with chronic stroke participated in the intrarater and interrater reliability studies, respectively; 60 inpatients who had recently had a stroke participated in the responsiveness study.


METHODS
Not applicable.
The intraclass correlation coefficient values were .94 and .80 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The classical test theory-based minimal detectable change values were 6.5 and 9.5 for the ADL CAT in the intrarater reliability and interrater reliability studies, respectively. The Kazis' effect size and standardized response mean of the ADL CAT were moderate (.62-.73).


CONCLUSIONS
The ADL CAT has good intrarater reliability and interrater reliability in outpatients with chronic stroke, and sufficient responsiveness in inpatients with stroke undergoing inpatient rehabilitation. Further investigations on the responsiveness of the ADL CAT in outpatients are needed to obtain more evidence on the utility of the ADL CAT.
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Ya-Chen
YC
Lee
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Wan-Hui
WH
Yu
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yu-Fen
YF
Lin
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: iping@ntu.edu.tw.
I-Ping
IP
Hsueh
Department of Physical Medicine and Rehabilitation, E-Da Hospital, Kaohsiung, Taiwan.
Hung-Chia
HC
Wu
School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Ching-Lin
CL
Hsieh
D000203:Activities of Daily Living; D000369:Aged, 80 and over; D003201:Computers; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires
Activities of daily living; Outcome assessment; Psychometrics; Rehabilitation; Reproducibility of results; Stroke