title: Reliability and validity of two versions of the upper extremity functional index.
abstract: OBJECTIVE
  To examine the reliability, validity, and sensitivity to change of the 20-item version and the Rasch-refined 15-item version of the Upper Extremity Functional Index (UEFI-20 and UEFI-15, respectively) and to determine the impact of arm dominance on the positive minimal clinically important difference (pMCID).
  
  
  METHODS
  Adults with upper-extremity (UE) dysfunction completed the UEFI-20, Upper Extremity Functional Scale (UEFS), Pain Limitation Scale, and Pain Intensity Scale at their initial physiotherapy assessment (Time 1); 24-48 hours later (Time 2); and 3 weeks into treatment or at discharge, whichever came first (Time 3). Demographics, including working status, were obtained at Time 1. Global ratings of change (GRC) were provided by the treating physiotherapist and patient at Time 3. The UEFI-15 was calculated from relevant items in the UEFI-20. The intra-class correlation coefficient (ICC) and minimal detectable change (MDC) quantified test-retest reliability (Time 1-Time 2). Cross-sectional convergent validity was determined by the association (Pearson's r) between Time 1 measures of function and pain. Known-groups validity was evaluated with a one-way ANOVA across three levels of working status. Longitudinal validity was determined by the association (Pearson's r) between function and pain change scores (Time 1-Time 3). Receiver operating characteristic (ROC) curves estimated the pMCID using Time 1-Time 3 change scores and average patient/therapist GRC.
  
  
  RESULTS
  Reliability for the UEFI-20 and UEFI-15 was the same (ICC=0.94 for both measures). MDC values were 9.4/80 for the UEFI-20 and 8.8/100 for the UEFI-15. Cross-sectional, known-groups, and longitudinal validity were confirmed for both UEFI measures. pMCID values were 8/80 for the UEFI-20 and 6.7/100 for the UEFI-15; pMCID was higher for people whose non-dominant arm was affected.
  
  
  CONCLUSIONS
  Both UEFI measures show acceptable reliability and validity. Arm dominance affects pMCID. The UEFI-15 is recommended because it measures only one dimension: UE function.
authors.affiliation: School of Physical Therapy ; Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences ; Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ont.
authors.forename: Bert M
authors.initials: BM
authors.lastname: Chesworth
authors.affiliation: Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences.
authors.forename: Clayon B
authors.initials: CB
authors.lastname: Hamilton
authors.affiliation: School of Physical Therapy.
authors.forename: David M
authors.initials: DM
authors.lastname: Walton
authors.affiliation: School of Physical Therapy.
authors.forename: Melissa
authors.initials: M
authors.lastname: Benoit
authors.affiliation: School of Physical Therapy.
authors.forename: Tracy A
authors.initials: TA
authors.lastname: Blake
authors.affiliation: School of Physical Therapy.
authors.forename: Heather
authors.initials: H
authors.lastname: Bredy
authors.affiliation: School of Physical Therapy.
authors.forename: Cameron
authors.initials: C
authors.lastname: Burns
authors.affiliation: School of Physical Therapy.
authors.forename: Lianne
authors.initials: L
authors.lastname: Chan
authors.affiliation: School of Physical Therapy.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Frey
authors.affiliation: School of Physical Therapy.
authors.forename: Graham
authors.initials: G
authors.lastname: Gillies
authors.affiliation: School of Physical Therapy.
authors.forename: Teresa
authors.initials: T
authors.lastname: Gravelle
authors.affiliation: School of Physical Therapy.
authors.forename: Rick
authors.initials: R
authors.lastname: Ho
authors.affiliation: School of Physical Therapy.
authors.forename: Robert
authors.initials: R
authors.lastname: Holmes
authors.affiliation: School of Physical Therapy.
authors.forename: Roland L J
authors.initials: RL
authors.lastname: Lavallée
authors.affiliation: School of Physical Therapy.
authors.forename: Melanie
authors.initials: M
authors.lastname: MacKinnon
authors.affiliation: School of Physical Therapy.
authors.forename: Alishah Jamal
authors.initials: AJ
authors.lastname: Merchant
authors.affiliation: School of Physical Therapy.
authors.forename: Tammy
authors.initials: T
authors.lastname: Sherman
authors.affiliation: School of Physical Therapy.
authors.forename: Kelly
authors.initials: K
authors.lastname: Spears
authors.affiliation: School of Physical Therapy.
authors.forename: Darryl
authors.initials: D
authors.lastname: Yardley
keywords: ROC curve; outcome assessment; physiology; reproducibility of results; upper limb