Goljar Nika, Giordano Andrea, Schnurrer Luke Vrbanić Tea, Rudolf Marko, Banicek-Sosa Ivanka, Albensi Caterina, Burger Helena, Franchignoni Franco
aUniversity Rehabilitation Institute of Republic of Slovenia, Ljubljana, Slovenia bUnit of Bioengineering, Clinical Scientific Institutes Maugeri, Institute of Veruno (NO), Veruno cSchool of Specialization in Physical and Rehabilitation Medicine, Tor Vergata University, Rome, Italy dDepartment of Neurorehabilitation, Physical & Rehabilitation Medicine Centre, University Hospital Rijeka, Rijeka, Croatia.
Int J Rehabil Res. 2017 Sep;40(3):232-239. doi: 10.1097/MRR.0000000000000233.
We aimed to verify by Rasch analysis whether the Mini-BESTest, a balance measure, confirms its main psychometric properties in patients with subacute stroke undergoing rehabilitation in three different countries (Slovenia, Croatia, and Italy), and to examine the stability of item hierarchy and difficulty across the three national versions through a differential item functioning analysis. We investigated 159 patients with subacute stroke consecutively admitted to three rehabilitation facilities after screening for an intensive, tailored rehabilitation program. Balance function was tested within 36 h from admission and after ∼25 days. As no differential item functioning was found between admission and discharge data or among countries, all data were pooled. Rasch criteria for the functioning of rating scale categories were fulfilled. In terms of internal construct validity, all items except item #14 (Cognitive Get Up & Go; infit value=1.42) showed an acceptable fit to the Rasch model. The patient ability-item difficulty matching was very good. Reliability indices were high. The Principal Component Analysis of standardized residuals confirmed the unidimensionality of the test. On the basis of the item calibration, raw scores of the Mini-BESTest were transformed into linear estimates of dynamic balance and six statistically detectable levels of balance ability were defined. Good psychometric features of the Mini-BESTest were confirmed. The three different national versions showed stability in item hierarchy, indicating equivalence of their cross-cultural adaptations. Problems with item #14 in these patients warrant further study.
我们旨在通过拉施分析验证平衡测量工具Mini-BESTest在斯洛文尼亚、克罗地亚和意大利这三个不同国家接受康复治疗的亚急性中风患者中是否能证实其主要心理测量学特性，并通过差异项目功能分析来检验三个国家版本中项目层次和难度的稳定性。我们对159例亚急性中风患者进行了调查，这些患者在筛选出强化的、量身定制的康复项目后，连续入住三个康复机构。在入院后36小时内及大约25天后对平衡功能进行测试。由于在入院和出院数据之间或不同国家之间未发现差异项目功能，因此将所有数据合并。评分量表类别的功能符合拉施标准。在内部结构效度方面，除项目#14（认知起身与行走；拟合值=1.42）外，所有项目对拉施模型的拟合度均可接受。患者能力与项目难度匹配良好。可靠性指标较高。标准化残差的主成分分析证实了该测试的单维度性。根据项目校准，将Mini-BESTest的原始分数转换为动态平衡的线性估计值，并定义了六个统计学上可检测的平衡能力水平。Mini-BESTest良好的心理测量学特征得到了证实。三个不同的国家版本在项目层次上表现出稳定性，表明其跨文化适应性的等效性。这些患者中项目#14存在的问题值得进一步研究。
