Lin GH, Huang YJ, Lee SC, Huang SL, Hsieh CL. Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke.
Arch Phys Med Rehabil 2017;
99:676-683. [PMID:
29042171 DOI:
10.1016/j.apmr.2017.09.116]
[Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 08/23/2017] [Accepted: 09/24/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE
To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.
DESIGN
Simulation study.
SETTING
One rehabilitation unit in a medical center.
PARTICIPANTS
Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%).
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index.
RESULTS
The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88-.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91-.95) and responsiveness (standardized response mean, .65-.76) of the CAT-FAS were good in patients with stroke.
CONCLUSIONS
We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients.
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