To determine how well the Neuromuscular Recovery Scale (NRS) items fit the Rasch, 1-parameter, partial-credit measurement model.
Confirmatory factor analysis (CFA) and principal components analysis (PCA) of residuals were used to determine dimensionality. The Rasch, 1-parameter, partial-credit rating scale model was used to determine rating scale structure, person/item fit, point-measure item correlations, item discrimination, and measurement precision.
Seven NeuroRecovery Network clinical sites.
Outpatients (N=188) with spinal cord injury.
Main Outcome Measure
While the NRS met 1 of 3 CFA criteria, the PCA revealed that the Rasch measurement dimension explained 76.9% of the variance. Ten of 11 items and 91% of the patients fit the Rasch model, with 9 of 11 items showing high discrimination. Sixty-nine percent of the ratings met criteria. The items showed a logical item-difficulty order, with Stand retraining as the easiest item and Walking as the most challenging item. The NRS showed no ceiling or floor effects and separated the sample into almost 5 statistically distinct strata; individuals with an American Spinal Injury Association Impairment Scale (AIS) D classification showed the most ability, and those with an AIS A classification showed the least ability. Items not meeting the rating scale criteria appear to be related to the low frequency counts.
The NRS met many of the Rasch model criteria for construct validity.
List of abbreviations:AIS (American Spinal Injury Association Impairment Scale), CFA (confirmatory factor analysis), NRN (NeuroRecovery Network), NRS (Neuromuscular Recovery Scale), PCA (principal components analysis), SCI (spinal cord injury)
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- Current concerns in validity theory.J Educ Meas. 2001; 38: 319-342
- Validity: foundational issues and statistical methodology.in: Rao C.R. Sinharay S. Handbook of statistics. (vol 26). Elsevier B.V., Waltham2006: 45-79
- Five perspectives on validity argument.in: Braun H.W. Test validity. Lawrence Erlbaum, Hillsdale1988: 3-17
- Improving measurement methods in rehabilitation: core concepts and recommendations for scale development.Arch Phys Med Rehabil. 2012; 93: S154-S163
- Rasch analysis of the Gross Motor Function Measure: validating the assumptions of the Rasch model to create an interval-level measure.Arch Phys Med Rehabil. 2003; 84: 697-705
- A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation.Spinal Cord. 2007; 45: 275-291
- Mplus user's guide.Muthen & Muthen, Los Angeles2001
- Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS).Med Care. 2007; 45: S22-31
- WINSTEPS Rasch-model computer programs program manual 3.75.0.Winsteps.com, Beaverton2012
- Optimizing rating scale category effectiveness.J Appl Meas. 2002; 3: 85-106
- Reasonable mean-square fit values.Rasch Meas Trans. 1994; 8: 370
- Rating scale analysis.Mesa Pr, Chicago1982
- Assessment of functional improvement without compensation reduces variability of outcome measures after human spinal cord injury.Arch Phys Med Rehabil. 2012; 93: 1518-1529
- Interrater reliability of the Neuromuscular Recovery Scale for spinal cord injury.Arch Phys Med Rehabil. 2015; 96: 1397-1403
- Test-retest reliability of the Neuromuscular Recovery Scale.Arch Phys Med Rehabil. 2015; 96: 1375-1384
- Arm reaching improvements with short-term practice depend on the severity of the motor deficit in stroke.Exp Brain Res. 2003; 152: 476-488
- Task-specific training with trunk restraint on arm recovery in stroke: randomized control trial.Stroke. 2006; 37: 186-192
- Why voluntary postural training improves recovery of mental and motor functions in patients with traumatic brain injury?.J Behav Brain Sci. 2013; 3: 463-473
- Challenge point: a framework for conceptualizing the effects of various practice conditions in motor learning.J Mot Behav. 2004; 36: 212-224
- Feasibility and potential efficacy of high-intensity stepping training in variable contexts in subacute and chronic stroke.Neurorehabil Neural Repair. 2014; 28: 643-651
Published online: April 22, 2015
Supported by the Craig H. Neilsen Foundation (grant no. 164521).
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
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- Interrater Reliability of the Neuromuscular Recovery Scale for Spinal Cord InjuryArchives of Physical Medicine and RehabilitationVol. 96Issue 8
- PreviewTo determine the interrater reliability of the Neuromuscular Recovery Scale (NRS), an outcome measure designed to classify people with complete or incomplete spinal cord injury (SCI) into 4 phase-of-injury groups by assessing motor performance based on normal preinjury function and disallowing use of compensation for 4 treadmill-based items and 6 overground/mat items.
- Test-Retest Reliability of the Neuromuscular Recovery ScaleArchives of Physical Medicine and RehabilitationVol. 96Issue 8