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Errante A, Beccani L, Verzelloni J, Maggi I, Filippi M, Bressi B, Ziccarelli S, Bozzetti F, Costi S, Ferrari A, Fogassi L. Effectiveness of action observation treatment based on pathological model in hemiplegic children: a randomized-controlled trial. Eur J Phys Rehabil Med 2024; 60:643-655. [PMID: 38814197 DOI: 10.23736/s1973-9087.24.08413-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Abstract
BACKGROUND Action observation treatment (AOT) is an innovative therapeutic approach consisting in the observation of actions followed by their subsequent repetition. The standard version of AOT consists in the observation/imitation of a typically developed individual, which is proposed as model (TDM-AOT). AIM This study aims to compare the effectiveness of AOT based on a pathological ameliorative model (PAM-AOT) versus TDM-AOT in improving upper limb ability in children with unilateral cerebral palsy (UCP). DESIGN The study consists in a prospective randomized controlled, evaluator-blinded trial (RCT), with two active arms, designed to evaluate the effectiveness of AOT based on pathological model (PAM-AOT) as compared to a standard AOT based on TDM (TDM-AOT). SETTING The 3-week AOT program was administered in a clinical setting. For some patients, the treatment was delivered at participant's home with the remote support of the physiotherapist (tele-rehabilitation). POPULATION Twenty-six children with UCP (mean age 10.5±3.09 years; 14 females) participated in the study, with the experimental group observing a pathological model and the control group observing a typically developed model. METHODS Motor assessments included unimanual and bimanual ability measures conducted at T0 (baseline, before the treatment), T1 (3 weeks after T0), T2 (8-12 weeks after treatment) and T3 (24-28 weeks after treatment); a subset of 16 patients also underwent fMRI motor assessment. Generalized Estimating Equations models were used for statistical analysis. RESULTS Both groups showed significant improvement in bimanual function (GEE, Wald 106.16; P<0.001) at T1 (P<0.001), T2 (P<0.001), and T3 (P<0.001). Noteworthy, the experimental group showed greater improvement than the control group immediately after treatment (P<0.013). Both groups exhibited similar improvement in unimanual ability (GEE, Wald 25.49; P<0.001). The fMRI assessments revealed increased activation of ventral premotor cortex after treatment in the experimental compared with control group (GEE, Wald 6.26; P<0.012). CONCLUSIONS Overall, this study highlights the effectiveness of PAM-AOT in achieving short-term improvement of upper limb ability in children with UCP. CLINICAL REHABILITATION IMPACT These findings have significant implications for rehabilitative interventions based on AOT in hemiplegic children, by proposing a non-traditional approach focused on the most functional improvement achievable by imitating a pathological model.
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Affiliation(s)
- Antonino Errante
- Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Laura Beccani
- Unit of Severe Disabilities of Developmental Age (UDGEE), Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Jessica Verzelloni
- Unit of Severe Disabilities of Developmental Age (UDGEE), Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Irene Maggi
- Unit of Severe Disabilities of Developmental Age (UDGEE), Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Mariacristina Filippi
- Unit of Severe Disabilities of Developmental Age (UDGEE), Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | | | | | - Stefania Costi
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Scientific Directorate, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Adriano Ferrari
- Unit of Severe Disabilities of Developmental Age (UDGEE), Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Leonardo Fogassi
- Department of Medicine and Surgery, University of Parma, Parma, Italy -
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Tesio L, Caronni A, Simone A, Kumbhare D, Scarano S. Interpreting results from Rasch analysis 2. Advanced model applications and the data-model fit assessment. Disabil Rehabil 2024; 46:604-617. [PMID: 36744832 DOI: 10.1080/09638288.2023.2169772] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 01/10/2023] [Indexed: 02/07/2023]
Abstract
Purpose: The present paper presents developments and advanced practical applications of Rasch's theory and statistical analysis to construct questionnaires for measuring a person's traits. The flaws of questionnaires providing raw scores are well known. Scores only approximate objective, linear measures. The Rasch Analysis allows you to turn raw scores into measures with an error estimate, satisfying fundamental measurement axioms (e.g., unidimensionality, linearity, generalizability). A previous companion article illustrated the most frequent graphic and numeric representations of results obtained through Rasch Analysis. A more advanced description of the method is presented here.Conclusions: Measures obtained through Rasch Analysis may foster the advancement of the scientific assessment of behaviours, perceptions, skills, attitudes, and knowledge so frequently faced in Physical and Rehabilitation Medicine, not less than in social and educational sciences. Furthermore, suggestions are given on interpreting and managing the inevitable discrepancies between observed scores and ideal measures (data-model "misfit"). Finally, twelve practical take-home messages for appraising published results are provided.Implications for rehabilitationThe current work is the second of two papers addressed to rehabilitation clinicians looking for an in-depth introduction to the Rasch analysis.The first paper illustrates the most common results reported in published papers presenting the Rasch analysis of questionnaires.The present article illustrates more advanced applications of the Rasch analysis, also frequently found in publications.Twelve take-home messages are given for a critical appraisal of the results.
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Affiliation(s)
- Luigi Tesio
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Antonio Caronni
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Anna Simone
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
| | - Dinesh Kumbhare
- Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Stefano Scarano
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy
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Sogbossi ES, Arnould C, Kpadonou TG, Batcho CS, Bleyenheuft Y. Measuring global activity performance in children with cerebral palsy in West Africa: validation of an adapted version of the ACTIVLIM-CP questionnaire. Disabil Rehabil 2024; 46:170-179. [PMID: 36495153 DOI: 10.1080/09638288.2022.2154083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/26/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE To calibrate a West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) for children with cerebral palsy (CP). MATERIALS AND METHODS We recruited 287 children with CP of various age range: 2-6 years (n = 117, preschoolers), 6-12 years (n = 96, children) and 12-19 years (n = 74, adolescents). Caregivers of children of each age range completed the experimental version of the ACTIVLIM-CP-WA including 76 (preschoolers), 78 (children) and 76 (adolescents) global daily life activities. Responses were analyzed using the Rasch RUMM2030 software. RESULTS The final West-African version of ACTIVLIM-CP including 31 items (both common and age-specific items) defined a unidimensional, linear scale with well-discriminated response categories. It presented a high internal consistency (R = 0.94). Moreover, all items were locally independent and the item difficulty hierarchy was invariant regarding caregivers' education, children's age and gender, MACS and GMFCS levels. The ACTIVLIM-CP-WA measures were significantly correlated (p < 0.05) with Gross Motor Function Classification System (ρ = -0.77), Manual Ability Classification System (ρ = -0.75), Box and Block test (dominant hand r = 0.51; non-dominant hand r = 0.49), One-minute walking test (r = 0.28), and Timed up and Go test (r = -0.40). CONCLUSIONS The ACTIVLIM-CP-WA questionnaire provides a valid and reliable tool that has the potential to follow children's evolution and quantify changes consecutive to neurorehabilitation in Sub-Saharan Africa.IMPLICATIONS FOR REHABILITATIONThe West-African version of the ACTIVLIM-CP questionnaire (ACTIVLIM-CP-WA) measures global activities requiring a combination of lower and upper extremities in children with cerebral palsy.As a Rasch-built scale, measures are unidimensional and linear to document changes in children with cerebral palsy from 2 to 19 years in Sub-Saharan Africa.Rehabilitation professionals are encouraged to use the ACTIVLIM-CP-WA questionnaire as a psychometrically robust assessment tool measuring the global performance in daily life activities in children with cerebral palsy in Sub-Saharan Africa.
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Affiliation(s)
- Emmanuel Segnon Sogbossi
- Motor Skill Learning and Intensive Neurorehabilitation Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
| | - Carlyne Arnould
- Forme & Fonctionnement Humain Lab, Physical and Occupational Therapy Departments, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Belgium
| | - Toussaint G Kpadonou
- School of Physical Therapy, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin
- Clinique Universitaire de Médecine Physique et Réadaptation, Centre National Hospitalier et Universitaire Hubert Koutoukou MAGA (CNHU-HKM) de Cotonou, Cotonou, Benin
| | - Charles Sebiyo Batcho
- Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Laval University, Quebec, Canada
- Department of Rehabilitation, Faculty of Medicine, Laval University, Quebec, Canada
| | - Yannick Bleyenheuft
- Motor Skill Learning and Intensive Neurorehabilitation Lab, Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
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Caronni A, Picardi M, Scarano S, Tropea P, Gilardone G, Bolognini N, Redaelli V, Pintavalle G, Aristidou E, Antoniotti P, Corbo M. Differential Item Functioning of the Mini-BESTest Balance Measure: A Rasch Analysis Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5166. [PMID: 36982075 PMCID: PMC10049698 DOI: 10.3390/ijerph20065166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The Mini-Balance Evaluation Systems Test (Mini-BESTest), a 14-item scale, has high content validity for balance assessment. This study further examines the construct validity of the Mini-BESTest with an emphasis on its measurement invariance. The Mini-BESTest was administered to 292 neurological patients in two sessions (before and after rehabilitation) and evaluated with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, sessions). Categories' order and fit to the model were assessed. Next, maps, dimensionality, and differential item functioning (DIF) were examined for construct validity evaluation. DIF was inspected for several clinically important variables, including session, diagnosis, and assistive devices. Mini-BESTest items had ordered categories and fitted the Rasch model. The item map did not flag severe construct underrepresentation. The dimensionality analysis showed that another variable extraneous to balance affected the score of a few items. However, this multidimensionality had only a modest impact on measures. Session did not cause DIF. DIF for assistive devices affected six items and caused a severe measurement artefact. The measurement artefact caused by DIF for diagnosis was negligible. The Mini-BESTest returns interval measures with robust construct validity and measurement invariance. However, caution should be used when comparing Mini-BESTest measures obtained with and without assistive devices.
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Affiliation(s)
- Antonio Caronni
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
| | - Michela Picardi
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Stefano Scarano
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20133 Milano, Italy
| | - Peppino Tropea
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Giulia Gilardone
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Nadia Bolognini
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20149 Milano, Italy
- Department of Psychology and NeuroMI, University of Milano-Bicocca, 20126 Milano, Italy
| | - Valentina Redaelli
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Giuseppe Pintavalle
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Evdoxia Aristidou
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Paola Antoniotti
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
| | - Massimo Corbo
- Department of Neurorehabilitation Sciences, Casa di Cura Igea, 20144 Milano, Italy
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Tesio L, Scarano S, Hassan S, Kumbhare D, Caronni A. Why Questionnaire Scores Are Not Measures: A Question-Raising Article. Am J Phys Med Rehabil 2023; 102:75-82. [PMID: 35700126 PMCID: PMC9770109 DOI: 10.1097/phm.0000000000002028] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
ABSTRACT Any person is provided by characteristics that can be neither located in body parts nor directly observed (so-called latent variables): these may be behaviors, attitudes, perceptions, motor and cognitive skills, knowledge, emotions, and the like. Physical and rehabilitation medicine frequently faces variables of this kind, the target of many interventions. Latent variables can only be observed through representative behaviors (e.g., walking for independence, moaning for pain, social isolation for depression, etc.). To measure them, behaviors are often listed and summated as items in cumulative questionnaires ("scales"). Questionnaires ultimately provide observations ("raw scores") with the aspect of numbers. Unfortunately, they are only a rough and often misleading approximation to true measures for various reasons. Measures should satisfy the same measurement axioms of physical sciences. In the article, the flaws hidden in questionnaires' scores are summarized, and their consequences in outcome assessment are highlighted. The report should inspire a critical attitude in the readers and foster the interest in modern item response theory, with reference to Rasch analysis.
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Affiliation(s)
- Luigi Tesio
- From the Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy (LT, SS); Istituto Auxologico Italiano, IRCCS, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy (LT, SS, AC); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (SH, DK); and Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (SH, DK)
| | - Stefano Scarano
- From the Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy (LT, SS); Istituto Auxologico Italiano, IRCCS, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy (LT, SS, AC); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (SH, DK); and Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (SH, DK)
| | - Samah Hassan
- From the Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy (LT, SS); Istituto Auxologico Italiano, IRCCS, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy (LT, SS, AC); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (SH, DK); and Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (SH, DK)
| | - Dinesh Kumbhare
- From the Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy (LT, SS); Istituto Auxologico Italiano, IRCCS, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy (LT, SS, AC); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (SH, DK); and Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (SH, DK)
| | - Antonio Caronni
- From the Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy (LT, SS); Istituto Auxologico Italiano, IRCCS, Department of Neurorehabilitation Sciences, Ospedale San Luca, Milan, Italy (LT, SS, AC); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Canada (SH, DK); and Pain Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Canada (SH, DK)
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Kınık M, Naz I. An investigation of the psychometric properties of the Turkish adaptation of the activity limitations in cerebral palsy questionnaire. Disabil Rehabil 2022:1-7. [PMID: 35866563 DOI: 10.1080/09638288.2022.2099586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To translate the ACTIVLIM-CP questionnaire, developed to assess global activity performance in children with Cerebral Palsy (CP), into Turkish and to investigate its psychometric properties. METHODS Eighty-nine children with CP, aged between 2 and 18 years (mean age: 10.08 ± 4.94 years), were included in the study. Internal consistency was measured by Cronbach's alpha and test-retest reliability was assessed using intraclass correlation coefficient (ICC). Convergent validity was evaluated through the pattern of correlations between the ACTIVLIM-CP with PEDI, ABILOCO-Kids, ABILHAND-Kids, and Wee-FIM scores. Known-group comparisons were made according to epilepsy existence and ambulation level measured by Gross Motor Function Classification System (GMFCS). RESULTS Internal consistency was excellent (Cronbach's α = 0.990), and the ICC for the test-retest reliability was 0.990. There was a very strong correlation between ACTIVLIM-CP and ABILHAND-Kids (r = 0.946), WeeFIM (r = 0.900), PEDI Functional Skills and Caregiver Assistance scores (r = 0.954, r = 0.937, respectively), and ABILOCO-Kids (r = 0.817) (p < 0.001) score. ACTIVLIM-CP score was lower in children with epilepsy (p = 0.001) and in the high-level group according to GMFCS (p < 0.001). CONCLUSION The Turkish adaptation of ACTIVLIM-CP is a valid and reliable scale for measuring activity limitations in children with CP and is compatible with other scales evaluating activity limitations. CLINICAL TRIAL NUMBER NCT05184244IMPLICATIONS FOR REHABILITATIONActivity limitation measurements are crucial and necessary to determine the global activity performance of children with CP.ACTIVLIM-CP was translated and culturally adapted to Turkish and showed good psychometric properties.ACTIVLIM-CP is a valid and reliable tool to evaluate activity performance in children with CP.
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Affiliation(s)
- Merve Kınık
- Institute of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
| | - Ilknur Naz
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey
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Can a pathological model improve the abilities of the paretic hand in hemiplegic children? The PAM-AOT study protocol of a randomised controlled trial. BMJ Open 2021. [PMCID: PMC8718426 DOI: 10.1136/bmjopen-2021-053910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction Action Observation Treatment (AOT) is an innovative therapeutic approach consisting in the observation of actions followed by subsequent repetition. In children with unilateral cerebral palsy (UCP), it improves upper limb function in daily activities. The standard paradigm of AOT requires the observation of healthy models; however, it has been demonstrated that the mirror neuron system of children with UCP is more activated by observation of pathological models, showing a similar motor repertoire, than by the healthy model, suggesting that AOT based on pathological models is superior to the standard paradigm of AOT in the functional rehabilitation of the affected upper limb of children with UCP. Methods and analysis This protocol describes an active two-arm randomised controlled evaluator-blinded trial. Twenty-six children with UCP will participate in 3 weeks of intensive AOT: the experimental group will observe a pathological model, while the control group will observe a typically developed model. The primary outcome is the spontaneous use of the paretic hand, measured with the Assisting Hand Assessment. Secondary outcome measures are the Melbourne Assessment of Unilateral Upper Limb Function, the ABILHAND-Kids and the Activities Scale for Kids-performance. Assessments will be performed at baseline (T0), at the end of intensive AOT (T1), at 8–12 weeks (T2) and at 24–28 weeks (T3) after the end of intensive AOT. Ethics and dissemination The trial was approved by the Area Vasta Emilia Nord Ethics Committee (AVEN prot. n. 133117, 29 November 2018), and it was prospectively registered on ClinicalTrials.gov. The results will be submitted for publication to a peer-reviewed journal, discussed with parents of children participating in the trial and disseminated at suitable conferences. Trial registration number NCT04088994; Pre-results.
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Got T, Bayley M, MacDonald S. Physiatry Reviews for Evidence in Practice Second-Order Peer Review: Are Self-management Programs Effective for Community-Based Rehabilitation? Am J Phys Med Rehabil 2021; 100:e110-e112. [PMID: 33315612 DOI: 10.1097/phm.0000000000001668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Tiffany Got
- From the Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (TG); KITE Research Institute, Toronto Rehabilitation Institute-University Health Network, Toronto, Ontario, Canada (MB); Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada (MB, SM); and Bridgepoint Active Healthcare, Sinai Health, Toronto, Ontario, Canada (SM)
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Mul K, Horlings CG, Faber CG, van Engelen BG, Merkies IS. Rasch analysis to evaluate the motor function measure for patients with facioscapulohumeral muscular dystrophy. Int J Rehabil Res 2021; 44:38-44. [PMID: 33165002 PMCID: PMC7884240 DOI: 10.1097/mrr.0000000000000444] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 10/19/2020] [Indexed: 02/03/2023]
Abstract
Patient-relevant outcome measures for facioscapulohumeral muscular dystrophy (FSHD) are needed. The motor function measure (MFM) is an ordinal-based outcome measure for neuromuscular disorders, but its suitability to measure FSHD patients is questionable. Here, we performed Rasch analyses on MFM data from 194 FSHD patients to assess clinimetric properties in this patient group. Both the total scale and its three domains were analyzed (D1: standing position and transfers; D2: axial and proximal motor function; D3: distal motor function). Fit to the Rasch model, sample-item targeting, individual item fit, threshold ordering, sex- and age-based differential item functioning, response dependency and unidimensionality were assessed. Rasch analysis revealed multiple limitations of the MFM for FSHD, the most important being a large ceiling effect and suboptimal sample-item targeting, which were most pronounced for domains D2 and D3. There were disordered thresholds for most items, often resulting in items functioning in a dichotomous fashion. It was not possible to remodel the MFM into a Rasch-built interval scale. Remodeling of domain D1 into an interval scale with adequate fit statistics was achieved, but sample-item targeting remained suboptimal. Therefore, the MFM should be used with caution in FSHD patients, as it is not optimally suited to measure functional abilities in this patient group.
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Affiliation(s)
- Karlien Mul
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Corinne G.C. Horlings
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Catharina G. Faber
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht
| | - Baziel G.M. van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen
| | - Ingemar S.J. Merkies
- Department of Neurology, School of Mental Health and Neuroscience, Maastricht University Medical Center+, Maastricht
- Department of Neurology, Curaçao Medical Center, Willemstad, Curaçao, The Netherlands
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El Khoury G, Barbier O, Libouton X, Thonnard JL, Lefèvre P, Penta M. Manual ability in hand surgery patients: Validation of the ABILHAND scale in four diagnostic groups. PLoS One 2020; 15:e0242625. [PMID: 33270681 PMCID: PMC7714184 DOI: 10.1371/journal.pone.0242625] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 11/05/2020] [Indexed: 11/23/2022] Open
Abstract
Background Patients treated in hand surgery (HS) belong to different demographic groups and have varying impairments related to different pathologies. HS outcomes are measured to assess treatment results, complication risks and intervention reliability. A one-dimensional and linear measure would allow for unbiased comparisons of manual ability between patients and different treatment effects. Objective To adapt the ABILHAND questionnaire through Rasch analysis for specific use in HS patients and to examine its validity. Methods A preliminary 90-item questionnaire was presented to 216 patients representing the diagnoses most frequently encountered in HS, including distal radius fracture (n = 74), basal thumb arthritis (n = 66), carpal tunnel syndrome (n = 53), and heavy wrist surgery (n = 23). Patients were assessed during the early recovery and in the late follow-up period (0–3 months, 3–6 months and >6 months), leading to a total of 305 assessments. They rated their perceived difficulty with queried activities as impossible, difficult, or easy. Responses were analyzed using the RUMM2030 software. Items were refined based on item-patient targeting, fit statistics, differential item functioning, local independence and item redundancy. Patients also completed the QuickDASH, 12-item Short Form Survey (SF-12) and a numerical pain scale. Results The rating scale Rasch model was used to select 23 mostly bimanual items on a 3-level scale, which constitute a unidimensional, linear measure of manual ability with good reliability across all included diagnostic groups (Person-Separation Index = 0.90). The resulting scale was found to be invariant across demographic and clinical subgroups and over time. ABILHAND-HS patient measures correlated significantly (p<0.001) with the QuickDASH (r = -0.77), SF-12 Physical Component Summary (r = 0.56), SF-12 Mental Component Summary (r = 0.31), and pain scale (r = -0.49). Conclusion ABILHAND-HS is a robust person-centered measure of manual ability in HS patients.
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Affiliation(s)
- Ghady El Khoury
- Service d’Orthopédie et Traumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- * E-mail:
| | - Olivier Barbier
- Service d’Orthopédie et Traumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Xavier Libouton
- Service d’Orthopédie et Traumatologie, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Jean-Louis Thonnard
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Philippe Lefèvre
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Institute of Information and Communication Technologies, Electronics and Applied Mathematics, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
| | - Massimo Penta
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
- Arsalis SRL, Glabais, Belgium
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Smith BW, Chang KWC, Saake SJ, Yang LJS, Chung KC, Brown SH. Quantifying Real-World Upper-Limb Activity Via Patient-Initiated Movement After Nerve Reconstruction for Upper Brachial Plexus Injury. Neurosurgery 2020; 85:369-374. [PMID: 30060090 DOI: 10.1093/neuros/nyy335] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 06/21/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND A critical concept in brachial plexus reconstruction is the accurate assessment of functional outcomes. The current standard for motor outcome assessment is clinician-elicited, outpatient clinic-based, serial evaluation of range of motion and muscle power. However, discrepancies exist between such clinical measurements and actual patient-initiated use. We employed emerging technology in the form of accelerometry-based motion detectors to quantify real-world arm use after brachial plexus surgery. OBJECTIVE To evaluate (1) the ability of accelerometry-based motion detectors to assess functional outcome and (2) the real-world arm use of patients after nerve transfer for brachial plexus injury, through a pilot study. METHODS Five male patients who underwent nerve transfer after brachial plexus injury wore bilateral motion detectors for 7 d. The patients also underwent range-of-motion evaluation and completed multiple patient-reported outcome surveys. RESULTS The average age of the recruits was 41 yr (±17 yr), and the average time from operation was 2 yr (±1 yr). The VT (time of use ratio) for the affected side compared to the unaffected side was 0.73 (±0.27), and the VM (magnitude ratio) was 0.63 (±0.59). VT strongly and positively correlated with shoulder flexion and shoulder abduction: 0.97 (P = .008) and 0.99 (P = .002), respectively. CONCLUSION Accelerometry-based activity monitors can successfully assess real-world functional outcomes after brachial plexus reconstruction. This pilot study demonstrates that patients after nerve transfer are utilizing their affected limbs significantly in daily activities and that recovery of shoulder function is critical.
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Affiliation(s)
- Brandon W Smith
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Kate W-C Chang
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Serena J Saake
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Lynda J-S Yang
- Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Kevin C Chung
- Section of Plastic Surgery, Department of Surgery, University of Michigan, Ann Arbor, Michigan
| | - Susan H Brown
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan
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12
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Paradis J, Arnould C, Bleyenheuft Y. Normative values and discriminative ability across functional levels of ACTIVLIM-CP, a measure of global activity performance for children with cerebral palsy. Disabil Rehabil 2019; 42:2790-2796. [PMID: 30973788 DOI: 10.1080/09638288.2019.1573270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: This study aims to provide normative values of a global activity performance questionnaire (ACTIVLIM-CP) and investigate its ability to discriminate children with cerebral palsy of various functional levels.Methods: Parents of 503 typically developing children aged 2-18 years old (mean age ± standard deviation (SD): 9.56 ± 4.62 years) and 285 children with cerebral palsy aged 2-18 years old (mean age ± SD: 10.08 ± 4.09 years) answered ACTIVLIM-CP. To provide normative values, influence of typically developing children's characteristics on ACTIVLIM-CP measures was investigated with a multiple linear regression. A Kruskal-Wallis test and Dunn's post-hoc tests were performed to investigate age differences in ACTIVLIM-CP measures. Discriminative ability of ACTIVLIM-CP was investigated using a one-way analysis of variance and post-hoc tests between children with cerebral palsy who differed in manual and gross motor functional levels.Results: In typically developing children, age was the strongest predictor, explaining 74% of the variance of ACTIVLIM-CP measures (β = 0.86, t = 38.21, p < 0.001). ACTIVLIM-CP measure increased with age until 17-18 years old where all children reached the maximal value, although 50% of the children at 12 years old already reached the maximal measure. Normative values were developed for each age bracket. In addition, ACTIVLIM-CP was able to discriminate children with CP's performance measures across most manual ability and gross motor functional levels.Conclusions: Normative values developed in this study with a representative sample of typically developing children allow clinicians to appraise the functional delay of children with cerebral palsy from the normal development of global activity performance. The good discriminative ability of ACTIVLIM-CP support its precision, construct validity, and clinical relevance to describe global activity limitations in children with cerebral palsy with manual ability levels and gross motor function levels II-V.Implications for rehabilitationNormative data of ACTIVLIM-CP developed with a representative sample of typically developing children can be used with children with CP to differentiate the age effect from the disruption caused by cerebral palsy.ACTIVLIM-CP showed the ability to discriminate across children with cerebral palsy having different manual and gross motor function, highlighting its precision, construct validity, and its clinical relevance to describe limitations in children with manual ability levels and gross motor function levels II-V.ACTIVLIM-CP covers a wide age range, is a cost-effective, easy and freely-available assessment of global activity performance in activities of daily living for clinicians.
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Affiliation(s)
- Julie Paradis
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
| | - Carlyne Arnould
- Physical and Occupational Therapy Department, Haute Ecole Louvain en Hainaut, Charleroi, Belgium
| | - Yannick Bleyenheuft
- Institute of Neuroscience, Université Catholique de Louvain, Brussels, Belgium
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13
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Niama Natta DD, Batcho CS, Stoquart GG, Alagnidé E, Kpadonou T, Lejeune TM. Evaluation of manual ability in stroke patients in Benin: cultural adaptation and Rasch validation of the ABILHAND-Stroke questionnaire. Eur J Phys Rehabil Med 2019; 55:19-28. [DOI: 10.23736/s1973-9087.18.05195-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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14
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Paradis J, Arnould C, Thonnard JL, Houx L, Pons-Becmeur C, Renders A, Brochard S, Bleyenheuft Y. Responsiveness of the ACTIVLIM-CP questionnaire: measuring global activity performance in children with cerebral palsy. Dev Med Child Neurol 2018; 60:1178-1185. [PMID: 29869417 DOI: 10.1111/dmcn.13927] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2018] [Indexed: 11/29/2022]
Abstract
AIM To investigate the responsiveness of the ACTIVLIM-CP questionnaire after two evidence-based interventions for children with cerebral palsy (CP). METHOD Seventy-five children with CP either participated in an intensive motor-skill learning intervention (hand-arm bimanual intensive therapy including lower extremities [HABIT-ILE], n=47) or received botulinum neurotoxin-A (BoNT-A) injection(s) into lower extremities combined with conventional physical therapy (n=28). All children were assessed three times: at baseline (T0 ; before HABIT-ILE/the day of BoNT-A injection), at T1 (last day of HABIT-ILE/6wks after BoNT-A injection), and at follow-up (T2 ; 3-4mo after the beginning of intervention). Parents completed ACTIVLIM-CP and three other activity questionnaires. Responsiveness was analysed using group (based on intervention), subgroup (based on gross motor function level), and individual approaches. RESULTS For the HABIT-ILE group, significant improvements in ACTIVLIM-CP were observed for the T0 -T1 period (p<0.001) but not for the T1 -T2 period. No significant changes were found in the BoNT-A group during assessments (p=0.84). In the subgroup analysis for the HABIT-ILE group (T0 -T1 ), greater changes were demonstrated for children in Gross Motor Function Classification System levels III and IV (p<0.001, effect size=1.36). The individual approach was congruent with the group approach. INTERPRETATION ACTIVLIM-CP demonstrated high responsiveness after HABIT-ILE, showing that this scale may be used to investigate global activity performance in clinical trials focusing on improving daily life activities. WHAT THIS PAPER ADDS Good responsiveness of ACTIVLIM-CP questionnaire during intensive motor-skill learning intervention. Higher responsiveness for children in Gross Motor Function Classification System (GMFCS) levels III and IV versus I and II after intensive intervention. ACTIVLIM-CP is useful to identify children improving their performance after botulinum neurotoxin-A injection.
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Affiliation(s)
- Julie Paradis
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium
| | - Carlyne Arnould
- Physical and Occupational Therapy Department, Haute Ecole Louvain en Hainaut, Montignies-sur-Sambre, Charleroi, Belgium
| | - Jean-Louis Thonnard
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium
| | - Laëtitia Houx
- Physical and Rehabilitation Medicine Department, CHRU de Brest, Brest, France.,Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
| | - Christelle Pons-Becmeur
- Physical and Rehabilitation Medicine Department, CHRU de Brest, Brest, France.,Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
| | - Anne Renders
- Cliniques Universitaires Saint-Luc, Physical and Rehabilitation Medicine Department, Université catholique de Louvain, Brussels, Belgium
| | - Sylvain Brochard
- Physical and Rehabilitation Medicine Department, CHRU de Brest, Brest, France.,Pediatric Rehabilitation Department, Fondation Ildys, Brest, France
| | - Yannick Bleyenheuft
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium
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Adroher ND, Prodinger B, Fellinghauer CS, Tennant A. All metrics are equal, but some metrics are more equal than others: A systematic search and review on the use of the term 'metric'. PLoS One 2018; 13:e0193861. [PMID: 29509813 PMCID: PMC5839589 DOI: 10.1371/journal.pone.0193861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 02/19/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine the use of the term 'metric' in health and social sciences' literature, focusing on the interval scale implication of the term in Modern Test Theory (MTT). MATERIALS AND METHODS A systematic search and review on MTT studies including 'metric' or 'interval scale' was performed in the health and social sciences literature. The search was restricted to 2001-2005 and 2011-2015. A Text Mining algorithm was employed to operationalize the eligibility criteria and to explore the uses of 'metric'. The paradigm of each included article (Rasch Measurement Theory (RMT), Item Response Theory (IRT) or both), as well as its type (Theoretical, Methodological, Teaching, Application, Miscellaneous) were determined. An inductive thematic analysis on the first three types was performed. RESULTS 70.6% of the 1337 included articles were allocated to RMT, and 68.4% were application papers. Among the number of uses of 'metric', it was predominantly a synonym of 'scale'; as adjective, it referred to measurement or quantification. Three incompatible themes 'only RMT/all MTT/no MTT models can provide interval measures' were identified, but 'interval scale' was considerably more mentioned in RMT than in IRT. CONCLUSION 'Metric' is used in many different ways, and there is no consensus on which MTT metric has interval scale properties. Nevertheless, when using the term 'metric', the authors should specify the level of the metric being used (ordinal, ordered, interval, ratio), and justify why according to them the metric is at that level.
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Affiliation(s)
- Núria Duran Adroher
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Birgit Prodinger
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
- Faculty of Applied Health and Social Sciences, University of Applied Sciences Rosenheim, Rosenheim, Germany
| | - Carolina Saskia Fellinghauer
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Alan Tennant
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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16
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Bleyenheuft Y, Paradis J, Renders A, Thonnard JL, Arnould C. ACTIVLIM-CP a new Rasch-built measure of global activity performance for children with cerebral palsy. RESEARCH IN DEVELOPMENTAL DISABILITIES 2017; 60:285-294. [PMID: 28341237 DOI: 10.1016/j.ridd.2016.10.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2016] [Revised: 09/13/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Children with cerebral palsy (CP) often have upper extremity (UE) and lower extremity (LE) impairments. While tools measuring separately UE and LE abilities are currently used, activities in which UE and LE are used in combination - numerous in everyday life - cannot be assessed because no instrument allows capturing global activity performance in children with CP. This study aimed to develop a clinical tool for measuring their global activity performance using the Rasch model. STUDY DESIGN The caregivers of 226 children with CP (2-18 years old) answered a 154-item experimental questionnaire. Within 4-6 weeks, 129 of them filled in the questionnaire a second time. Responses were analyzed using the Rasch RUMM2020 software. RESULTS The final 43 item scale presented a high reliability (R=0.98) and reproducibility (R=0.97). The item difficulty hierarchy was consistent over time and did not vary according to age, gender, or clinical form, allowing the follow-up of children from 2 to 18 years old. CONCLUSIONS ACTIVLIM-CP is a unidimensional scale specifically developed to measure global activity performance in children with CP providing a reliable tool to follow children's evolution and document changes related to neurorehabilitation, especially where a combination of UE and LE is targeted. Its responsiveness is still to be tested.
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Affiliation(s)
- Yannick Bleyenheuft
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium.
| | - Julie Paradis
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium; Service l'escale, CHU Lyon, Lyon, France
| | - Anne Renders
- Clinques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Jean-Louis Thonnard
- Institute of NeuroScience, Université catholique de Louvain, Brussels, Belgium; Clinques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Carlyne Arnould
- Haute Ecole Louvain en Hainaut, Physical and Occupational Therapy Department, Paramedical Category, Montignies-sur-Sambre, Belgium
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17
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Hill B, Pallant J, Williams G, Olver J, Ferris S, Bialocerkowski A. Evaluation of Internal Construct Validity and Unidimensionality of the Brachial Assessment Tool, A Patient-Reported Outcome Measure for Brachial Plexus Injury. Arch Phys Med Rehabil 2016; 97:2146-2156. [DOI: 10.1016/j.apmr.2016.06.021] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/02/2016] [Accepted: 06/26/2016] [Indexed: 11/30/2022]
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18
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Vanhoutte EK, Draak THP, Gorson KC, van Nes SI, Hoeijmakers JGJ, Van der Pol WL, Notermans NC, Lewis RA, Nobile-Orazio E, Léger JM, Van den Bergh PYK, Lauria G, Bril V, Katzberg H, Lunn MPT, Pouget J, van der Kooi AJ, Hahn AF, van Doorn PA, Cornblath DR, van den Berg LH, Faber CG, Merkies ISJ. Impairment measures versus inflammatory RODS in GBS and CIDP: a responsiveness comparison. J Peripher Nerv Syst 2016; 20:289-95. [PMID: 26114893 DOI: 10.1111/jns.12118] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 05/10/2015] [Accepted: 06/10/2015] [Indexed: 01/02/2023]
Abstract
This study aimed to 'define responder' through the concept of minimum clinically important differences using the individually obtained standard errors (MCID-SE) and a heuristic 'external criterion' responsiveness method in patients with Guillain-Barré syndrome (GBS) and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). One hundred and fourteen newly diagnosed or relapsing patients (GBS: 55, CIDP: 59) were serially examined (1-year follow-up). The inflammatory Rasch-built overall disability scale (I-RODS), Rasch-transformed MRC sum score (RT-MRC), and Rasch-transformed modified-INCAT-sensory scale (RT-mISS) were assessed. Being-a-responder was defined as having a MCID-SE cut-off ≥1.96. Also, the correlations between patients' scores on each scale and the EuroQoL health-status 'thermometer' (external criterion) were determined (higher correlation indicated better responsiveness). In both diseases, the SEs showed a characteristic 'U'-shaped dynamic pattern across each scales' continuum. The number of patients showing a meaningful change were higher for the I-RODS > RT-MRC > RT-mISS and were in GBS higher than CIDP patients. The MCID-SE concept using Rasch-transformed data demonstrated an individual pattern of 'being-a-responder' in patients with immune-mediated neuropathies, and the findings were validated by the external criterion responsiveness method. The I-RODS showed greater responsiveness compared with the MRC and INCAT-sensory scales, and its use is therefore recommended in future trials in GBS and CIDP.
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Affiliation(s)
- Els K Vanhoutte
- Department of Clinical Genetics, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Thomas H P Draak
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Kenneth C Gorson
- Department of Neurology, St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Sonja I van Nes
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | | | - W-Ludo Van der Pol
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Nicolette C Notermans
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Richard A Lewis
- Department of Neurology, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Eduardo Nobile-Orazio
- Department of Neurological Sciences, Humanitas Clinical Institute, Milan University, Milan, Italy
| | - Jean-Marc Léger
- Department of Neurology, Hôpital de la Salpêtrière, Paris, France
| | | | - Giuseppe Lauria
- Neuromuscular Diseases Unit, National Neurological Institute "Carlo Besta", Milan, Italy
| | - Vera Bril
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Hans Katzberg
- Department of Neurology, Toronto General Hospital, Toronto, Canada
| | - Michael P T Lunn
- Department of Neurology, Centre for Neuromuscular Disease, National Hospital for Neurology and Neurosurgery, London, UK
| | - Jean Pouget
- Department of Neurology, Centre de Référence des Maladies Neuromusculaires et de la SLA, Hôpital de La Timone, Marseille, France
| | | | - Angelika F Hahn
- Department of Neurology, London Health Science Center, London, Canada
| | - Pieter A van Doorn
- Department of Neurology, Erasmus Medical Centre Rotterdam, Rotterdam, The Netherlands
| | - David R Cornblath
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Leonard H van den Berg
- Department of Neurology, Rudolf Magnus Institute of Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Catharina G Faber
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Ingemar S J Merkies
- Department of Neurology, University Medical Centre Maastricht, Maastricht, The Netherlands.,Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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Hermans MCE, Hoeijmakers JGJ, Faber CG, Merkies ISJ. Reconstructing the Rasch-Built Myotonic Dystrophy Type 1 Activity and Participation Scale. PLoS One 2015; 10:e0139944. [PMID: 26484877 PMCID: PMC4618741 DOI: 10.1371/journal.pone.0139944] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 09/19/2015] [Indexed: 11/21/2022] Open
Abstract
Introduction A previously published Rasch-built activity and participation scale specifically designed for patients with myotonic dystrophy type 1 (DM1) was criticized for having been constructed in a relatively small cohort of patients and containing items too broadly phrased for DM1 patients, thus hampering its clinical use. Methods We report the results of the reconstructed Rasch-built DM1 activity and participation scale for clinical use (DM1-ActivC) through Rasch analyses using an expanded questionnaire containing 146 more simply phrased activity and participation inquiries completed by 340 patients with DM1. Results Through stepwise investigation including data quality control, model fit, response category ordering, local dependency and item bias, we succeeded in reconstructing the DM1-ActivC consisting of 25 items that showed good Rasch model fit, including construct convergent validity, items’ weights and persons’ locations reliability, and unidimensionality. Conclusion The DM1-ActivC scale has been reconstructed and fulfills all modern clinimetric requirements. Its use is recommended in future longitudinal trials in patients with DM1 to determine its responsiveness.
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Affiliation(s)
- Mieke C. E. Hermans
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Catharina G. Faber
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
- * E-mail:
| | - Ingemar S. J. Merkies
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
- Department of Neurology, Spaarne Hospital, Hoofddorp, The Netherlands
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Hill B, Bialocerkowski A, Williams G. Do patient reported outcome measures capture actual upper limb recovery? INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2014. [DOI: 10.12968/ijtr.2014.21.12.558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Bridget Hill
- Is a PhD candidate, School of Allied Health Sciences, Griffith University, Queensland, Australia
| | - Andrea Bialocerkowski
- Is deputy head of learning and teaching, School of Allied Health Sciences, Griffith University, Queensland, Australia
| | - Gavin Williams
- is a specialist neurological physiotherapist and research fellow, Epworth Hospital, Melbourne, Australia
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Sogbossi ES, Thonnard JL, Batcho CS. Assessing locomotion ability in West African stroke patients: validation of ABILOCO-Benin scale. Arch Phys Med Rehabil 2014; 95:1470-6.e3. [PMID: 24657111 DOI: 10.1016/j.apmr.2014.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Revised: 02/21/2014] [Accepted: 03/06/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To calibrate and validate the Benin version of ABILOCO, a Rasch-built scale developed to assess locomotion ability in stroke patients. DESIGN Prospective study and questionnaire development. SETTING Rehabilitation centers. PARTICIPANTS Stroke patients (N=230; mean age ± SD, 51.1±11.6 y; 64.3% men). INTERVENTION Not applicable. MAIN OUTCOME MEASURES Participants completed a preliminary list of 36 items including the 13 items of ABILOCO. Items were scored as "impossible," "difficult," or "easy." The mobility subdomain of FIM (FIM-mobility), the Functional Ambulation Classification (FAC), the 6-minute walk test (6MWT), and the 10-meter walk test (10MWT) were used to evaluate and elucidate the validity of the ABILOCO-Benin scale. RESULTS Successive Rasch analyses led to the selection of 15 items that define a unidimensional, invariant, and linear measure of locomotion ability in stroke patients. This modified version of the ABILOCO scale, named ABILOCO-Benin, showed an excellent internal consistency, with a Person Separation Index of .93, and excellent test-retest reliability with high intraclass correlation coefficients of .95 (P<.001) for item difficulty and .93 (P<.001) for subject measures. It also presented good construct validity compared with FAC, FIM-mobility, 6MWT, and 10MWT (r≥.75, P<.001). CONCLUSIONS ABILOCO-Benin presents good psychometric properties. It allows valid, reliable, and objective measurements of locomotion ability in stroke patients.
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Affiliation(s)
- Emmanuel Sègnon Sogbossi
- Department of Rehabilitation Medicine, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin; Department of Physiotherapy and Rehabilitation, Faculty of Motricity Sciences, Catholic University of Louvain, Brussels, Belgium
| | - Jean-Louis Thonnard
- Institute of Neuroscience, Catholic University of Louvain, Brussels, Belgium
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Norman KE, Héroux ME. Measures of fine motor skills in people with tremor disorders: appraisal and interpretation. Front Neurol 2013; 4:50. [PMID: 23717299 PMCID: PMC3650669 DOI: 10.3389/fneur.2013.00050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 04/24/2013] [Indexed: 12/04/2022] Open
Abstract
People with Parkinson's disease, essential tremor, or other movement disorders involving tremor have changes in fine motor skills that are among the hallmarks of these diseases. Numerous measurement tools have been created and other methods devised to measure such changes in fine motor skills. Measurement tools may focus on specific features - e.g., motor skills or dexterity, slowness in movement execution associated with parkinsonian bradykinesia, or magnitude of tremor. Less obviously, some tools may be better suited than others for specific goals such as detecting subtle dysfunction early in disease, revealing aspects of brain function affected by disease, or tracking changes expected from treatment or disease progression. The purpose of this review is to describe and appraise selected measurement tools of fine motor skills appropriate for people with tremor disorders. In this context, we consider the tools' content - i.e., what movement features they focus on. In addition, we consider how measurement tools of fine motor skills relate to measures of a person's disease state or a person's function. These considerations affect how one should select and interpret the results of these tools in laboratory and clinical contexts.
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Affiliation(s)
- Kathleen E. Norman
- School of Rehabilitation Therapy, Queen’s UniversityKingston, ON, Canada
- Centre for Neuroscience Studies, Queen’s UniversityKingston, ON, Canada
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Shigematsu K, Nakano H, Watanabe Y. The eye response test alone is sufficient to predict stroke outcome--reintroduction of Japan Coma Scale: a cohort study. BMJ Open 2013; 3:bmjopen-2013-002736. [PMID: 23633419 PMCID: PMC3641437 DOI: 10.1136/bmjopen-2013-002736] [Citation(s) in RCA: 229] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Prompt assessment of consciousness levels is vitally important during the emergency care of stroke patients. The Japan Coma Scale (JCS) is a one-axis coma scale published in 1974 with outstanding simplicity. The hypothesis is that JCS is sufficient to predict stroke outcome. The aim of the study was to verify the predictability of JCS, which should help JCS attain international recognition. DESIGN A cohort study. SETTING A prefectural stroke registry. PARTICIPANTS We analysed 13 788 stroke patients identified from January 1999 to December 2009 inclusive in the entire Kyoto prefecture and registered in the Kyoto Stroke Registry (KSR). MAIN OUTCOME MEASURES We investigated the relationship between consciousness levels, based on JCS at stroke onset and activities of daily living (ADL) at 30 days or deaths within 30 days in a large population-based stroke registry. We calculated Spearman's coefficient for the correlation between JCS and the ADL scale, generated estimated survival curves by the Kaplan-Meier method and finally compared HRs for death within 30 days after onset, comparing patients with different conscious levels based on JCS. RESULTS A total of 13 406 (97.2%) patients were graded based on JCS. JCS correlated to the ADL scale with Spearman's correlation coefficient of 0.61. HRs for death within 30 days were 1 (reference) (95% CIs), 5.55 (4.19 to 7.37), 9.54 (7.16 to 12.71) and 35.21 (26.10 to 44.83) in those scored as JCS0, JCS1, JCS2 and JCS3, respectively. CONCLUSIONS Using a single test of eye response, JCS has outstanding merits as a coma scale, that is, simplicity and applicability. The present study adds predictability for early outcome in stroke patients. JCS is valuable, especially in an emergency setting, when a prompt assessment of consciousness levels is needed.
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Affiliation(s)
- Kazuo Shigematsu
- Department of Neurology, National Hospital Organization, Minami Kyoto Hospital, Joyo, Kyoto, Japan
| | - Hiromi Nakano
- Department of Neurosurgery, Kyoto Kidugawa Hospital, Kyoto, Japan
| | - Yoshiyuki Watanabe
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan
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