Simone Anna, Rota Viviana, Tesio Luigi, Perucca Laura
Department of Neurorehabilitation Sciences, Istituto Auxologico Italiano, IRCCS, Milan, Italy.
Int J Rehabil Res. 2011 Jun;34(2):131-40. doi: 10.1097/MRR.0b013e328343d4d3.
ABILHAND is, in its original version, a 46-item, 4-level questionnaire. It measures the difficulty perceived by patients with rheumatoid arthritis as they do various daily manual tasks. ABILHAND was originally built through Rasch analysis. In a later study, it was simplified to a generic 23-item, three-level questionnaire, showing both cross-cultural (Belgium vs. Italy) and cross-impairment (rheumatoid arthritis vs. stroke) validity. Later research returned to the development of impairment-specific versions, with modified item sets and levels. Each version has its own Rasch-derived item difficulty calibrations, which are required to extract the patient's measure from the individual string of responses, through computerized algorithms. All of these hamper the practical application of the scale in rehabilitation units, where patients with diverse conditions may share similar impairments and treatment approaches. In this study through Rasch analysis the 'generic' scale was applied to 126 chronic patients with different upper limb impairments, and to 24 healthy controls. It was supported that the generic questionnaire remains valid across a variety of motor impairments. To further facilitate clinical application, a normative cut-off (>79 of 100) is suggested. Rasch-based item calibrations are provided together with a software routine designed to calculate, on individual patients, linear 0-100 measures and error estimates from the raw scores.
ABILHAND原始版本是一份包含46个条目的4级问卷。它测量类风湿关节炎患者在进行各种日常手工任务时所感知到的困难程度。ABILHAND最初是通过拉施分析构建的。在后来的一项研究中，它被简化为一份通用的23个条目、3级问卷，显示出跨文化（比利时与意大利）和跨损伤（类风湿关节炎与中风）效度。后来的研究又回到了针对特定损伤版本的开发，对条目集和等级进行了修改。每个版本都有其通过拉施分析得出的条目难度校准值，需要通过计算机算法从个体的回答序列中提取患者的测量值。所有这些都阻碍了该量表在康复单元中的实际应用，因为在康复单元中，不同病情的患者可能存在相似的损伤和治疗方法。在本研究中，通过拉施分析将该“通用”量表应用于126名患有不同上肢损伤的慢性病患者以及24名健康对照者。结果表明该通用问卷在各种运动损伤中仍然有效。为了进一步便于临床应用，建议设定一个标准临界值（100分中>79分）。同时提供基于拉施分析的条目校准值以及一个软件程序，该程序旨在根据个体患者的原始分数计算线性的0至100分测量值和误差估计值。
