Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taipei, Taiwan.
Department of Physical Medicine and Rehabilitation, National Taiwan University, Taipei, Taiwan.
Eur J Phys Rehabil Med. 2017 Oct;53(5):710-718. doi: 10.23736/S1973-9087.17.04454-9. Epub 2017 Feb 8.
A lack of evidence on the test-retest reliability and responsiveness limits the utility of the BI-based Supplementary Scales (BI-SS) in both clinical and research settings.
To examine the test-retest reliability and responsiveness of the BI-based Supplementary Scales (BI-SS) in patients with stroke.
A repeated-assessments design (1 week apart) was used to examine the test-retest reliability of the BI-SS. For the responsiveness study, the participants were assessed with the BI-SS and BI (treated as an external criterion) at admission to and discharge from rehabilitation wards.
Seven outpatient rehabilitation units and one inpatient rehabilitation unit.
Outpatients with chronic stroke.
Eighty-four outpatients with chronic stroke participated in the test-retest reliability study. Fifty-seven inpatients completed baseline and follow-up assessments in the responsiveness study.
For the test-retest reliability study, the values of the intra-class correlation coefficient and the overall percentage of minimal detectable change for the Ability Scale and Self-perceived Difficulty Scale were 0.97, 12.8%, and 0.78, 35.8%, respectively. For the responsiveness study, the standardized effect size and standardized response mean (representing internal responsiveness) of the Ability Scale and Self-perceived Difficulty Scale were 1.17 and 1.56, and 0.78 and 0.89, respectively. Regarding external responsiveness, the change in score of the Ability Scale had significant and moderate association with that of the BI (r=0.61, P<0.001). The change in score of the Self-perceived Difficulty Scale had non-significant and weak association with that of the BI (r=0.23, P=0.080).
The Ability Scale of the BI-SS has satisfactory test-retest reliability and sufficient responsiveness for patients with stroke. However, the Self-perceived Difficulty Scale of the BI-SS has substantial random measurement error and insufficient external responsiveness, which may affect its utility in clinical settings.
The findings of this study provide empirical evidence of psychometric properties of the BI-SS for assessing ability and self-perceived difficulty of ADL in patients with stroke.
基于 BI 的补充量表（BI-SS）在临床和研究环境中的测试重测信度和反应度的证据不足，限制了其效用。
检验基于 BI 的补充量表（BI-SS）在脑卒中患者中的测试重测信度和反应度。
采用重复评估设计（间隔 1 周）检验 BI-SS 的测试重测信度。对于反应度研究，在患者入住和离开康复病房时，用 BI-SS 和 BI（作为外部标准）对其进行评估。
7 家门诊康复单位和 1 家住院康复单位。
慢性脑卒中门诊患者。
84 例慢性脑卒中门诊患者参与了测试重测信度研究。57 例住院患者在反应度研究中完成了基线和随访评估。
在测试重测信度研究中，能力量表和自我感知困难量表的组内相关系数和最小可检测变化的总体百分比分别为 0.97、12.8%和 0.78、35.8%。在反应度研究中，能力量表和自我感知困难量表的标准化效应量和标准化反应均值（代表内部反应度）分别为 1.17 和 1.56，0.78 和 0.89。关于外部反应度，能力量表的评分变化与 BI 具有显著中度关联（r=0.61，P<0.001）。自我感知困难量表的评分变化与 BI 无显著弱关联（r=0.23，P=0.080）。
BI-SS 的能力量表在脑卒中患者中具有满意的测试重测信度和足够的反应度。然而，BI-SS 的自我感知困难量表存在大量随机测量误差和不足的外部反应度，这可能会影响其在临床环境中的应用。
本研究的结果为 BI-SS 评估脑卒中患者日常生活活动能力和自我感知困难提供了心理测量特性的实证证据。
