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European Journal of Physical and Rehabilitation Medicine 2021 Sep 09

DOI: 10.23736/S1973-9087.21.07029-5


language: English

Cross-cultural adaptation into italian and validation of the Frenchay Dysarthria Assessment-2

Valentina RIOLO 1, Nicole PIZZORNI 2 , Eleonora GUANZIROLI 1, Bruna AGOSTINIS 3, Megghi CONFORTOLA 4, Nicolò SCHETTINO 5, Giulia GILARDONE 6, Antonio SCHINDLER 2, Franco MOLTENI 1

1 Villa Beretta Rehabilitation Center, Valduce Hospital, Costa Masnaga, Lecco, Italy; 2 Department of Biomedical and Clinical Sciences Luigi Sacco, University of Milan, Milan, Italy; 3 Fondazione Renato Piatti, Varese, Italy; 4 UOC Neuropsichiatria dell'Infanzia e Adolescenza, ASST Valtellina e alto Lario, Sondrio, Italy; 5 ASST Lecco, Lecco, Italy; 6 Department of Neurorehabilitation Sciences, Casa di Cura del Policlinico, Milan, Italy


BACKGROUND: A comprehensive evaluation of dysarthria is required to make an accurate differential diagnosis with other communication disorders and plan effective rehabilitation programs. The Frenchay Dysarthria Assessment-2 (FDA-2) is a valid, reliable and widely-used protocol for the assessment of dysarthria. An Italian version of the FDA-2 is currently lacking.
AIM: To perform a cross-cultural adaptation of the FDA-2 in Italian and to validate the Italian version of the FDA-2.
DESIGN: Validation study.
SETTING: Inpatient rehabilitation center.
POPULATION: 69 patients with dysarthria and 112 healthy controls.
METHODS: The FDA-2 was translated and cross-culturally adapted to Italian. The validation study was carried out in 4 steps: (1) 42 audio-recorded samples of FDA-2 items from 11 patients with dysarthria were independently assessed by 7 speech and language pathologists for interrater reliability and re-assessed after 6 weeks for intrarater reliability; (2) 11 patients were simultaneously assessed by 3 speech and language therapists for interrater reliability of the whole Italian version of the FDA-2 and re-assessed within 24 hours for test-retest reliability; (3) the Italian version of the FDA-2 was administered to 112 healthy volunteers to gain normative data; (4) 49 patients with different types of dysarthria were assessed using the Italian version of the FDA-2, the Therapy Outcome Measure impairment scale and the Robertson Profile for the validity analysis.
RESULTS: Interrater and intrarater reliability ranged from good to excellent (ICC >0.75) except for 3 audiorecorded items. The overall protocol demonstrated excellent (ICC >0.9) inter-rater and test-retest reliability for all the sections and the total score. Normative data were gained for 6 age groups. For the validity analysis, a statistically significant difference was found between dysarthric patients and healthy subjects for all sections and the total score. The FDA-2 significantly correlated to the Therapy Outcome Measure (r=0.75) and the Robertson Profile (r=0.81).
CONCLUSIONS: The Italian version of the FDA-2 yield satisfactory reliability and validity, comparable to the psychometric properties of the original version.
CLINICAL REHABILITATION IMPACT: Speech and language pathologists can rely on a valid and reliable tool in Italian for the assessment of dysarthria in both clinical and research practice.

KEY WORDS: Dysarthria; Speech-language pathology; Validation study

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