验证和响应能力的晚年功能和残疾工具计算机自适应测试在社区居住的中风幸存者。

Validation and responsiveness of the Late-Life Function and Disability Instrument Computerized Adaptive Test in community-dwelling stroke survivors.

机构信息

Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands -

Physical Therapy Research, Department of Rehabilitation, Physical Therapy and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands -

出版信息

Eur J Phys Rehabil Med. 2019 Aug;55(4):424-432. doi: 10.23736/S1973-9087.18.05359-5. Epub 2018 Oct 29.

DOI:10.23736/S1973-9087.18.05359-5

PMID:30370749

Abstract

BACKGROUND

Follow-up of stroke survivors is important to objectify activity limitations and/or participations restrictions. Responsive measurement tools are needed with a low burden for professional and patient.

AIM

To examine the concurrent validity, floor and ceiling effects and responsiveness of both domains of the Late-Life Function and Disability Index Computerized Adaptive Test (LLFDI-CAT) in first-ever stroke survivors discharged to their home setting.

DESIGN

Longitudinal study.

SETTING

Community.

POPULATION

First ever stroke survivors.

METHODS

Participants were visited within three weeks after discharge and six months later. Stroke Impact Scale (SIS 3.0) and Five-Meter Walk Test (5MWT) outcomes were used to investigate concurrent validity of both domains, activity limitations, and participation restriction, of the LLFDI-CAT. Scores at three weeks and six months were used to examine floor and ceiling effects and change scores were used for responsiveness. Responsiveness was assessed using predefined hypotheses. Hypotheses regarding the correlations with change scores of related measures, unrelated measures, and differences between groups were formulated.

RESULTS

The study included 105 participants. Concurrent validity (R) of the LLFDI-CAT activity limitations domain compared with the physical function domain of the SIS 3.0 and with the 5MWT was 0.79 and -0.46 respectively. R of the LLFDI-CAT participation restriction domain compared with the participation domain of the SIS 3.0 and with the 5MWT was 0.79 and -0.41 respectively. A ceiling effect (15%) for the participation restriction domain was found at six months. Both domains, activity limitations and participation restrictions, of the LLFDI-CAT, scored well on responsiveness: 100% (12/12) and 91% (12/11) respectively of the predefined hypotheses were confirmed.

CONCLUSIONS

The LLFDI-CAT seems to be a valid instrument and both domains are able to detect change over time. Therefore, the LLFDI-CAT is a promising tool to use both in practice and in research.

CLINICAL REHABILITATION IMPACT

The LLFDI-CAT can be used in research and clinical practice.

摘要

背景

对脑卒中幸存者进行随访对于使活动受限和/或参与受限客观化很重要。需要一种具有低负担的响应式测量工具，供专业人员和患者使用。

目的

在首次脑卒中出院回家的幸存者中，检查晚年功能和残疾指数计算机化自适应测试（LLFDI-CAT）的两个领域的同时效度、地板和天花板效应以及响应能力。

设计

纵向研究。

地点

社区。

人群

首次脑卒中幸存者。

方法

参与者在出院后 3 周内和 6 个月后进行访视。使用脑卒中影响量表（SIS 3.0）和 5 米步行测试（5MWT）的结果来研究 LLFDI-CAT 的两个领域，即活动受限和参与受限，的同时效度。使用 3 周和 6 个月的分数来检查地板和天花板效应，并用变化分数来评估响应能力。使用预定的假设来评估响应能力。制定了关于与变化分数相关的措施、不相关的措施和组间差异的假设。

结果

本研究纳入了 105 名参与者。LLFDI-CAT 活动受限域与 SIS 3.0 的身体功能域和 5MWT 的相关性（R）分别为 0.79 和-0.46。LLFDI-CAT 参与受限域与 SIS 3.0 的参与域和 5MWT 的相关性（R）分别为 0.79 和-0.41。在 6 个月时，参与受限域发现了天花板效应（15%）。LLFDI-CAT 的两个领域，即活动受限和参与受限，在响应能力方面表现良好：分别有 100%（12/12）和 91%（12/11）的预设假设得到了证实。