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European Journal of Physical and Rehabilitation Medicine 2019 August;55(4):424-32

DOI: 10.23736/S1973-9087.18.05359-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

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

Roderick WONDERGEM 1, 2, 3 , Martijn F. PISTERS 1, 2, 3, Eveline M. WOUTERS 3, Rob A. de BIE 4, Johanna M. VISSER-MEILY 5, Cindy VEENHOF 1, 2, 6

1 Center for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, the Netherlands; 2 Physical Therapy Research, Department of Rehabilitation, Physical Therapy and Sport, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; 3 Department of Health Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, the Netherlands; 4 Department of Epidemiology and Caphri Research School, Maastricht University, Maastricht, the Netherlands; 5 Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands; 6 Expertise Center Innovation of Care, Research Group Innovation of Mobility Care, University of Applied Sciences Utrecht, Utrecht, the Netherlands



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.


KEY WORDS: Stroke; Activities of daily living; Survivors

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