Abstract
Objective
To determine how well the Neuromuscular Recovery Scale (NRS) items fit the Rasch,
1-parameter, partial-credit measurement model.
Design
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.
Setting
Seven NeuroRecovery Network clinical sites.
Participants
Outpatients (N=188) with spinal cord injury.
Interventions
Not applicable.
Main Outcome Measure
NRS.
Results
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.
Conclusions
The NRS met many of the Rasch model criteria for construct validity.
Keywords
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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: April 22, 2015
Footnotes
Supported by the Craig H. Neilsen Foundation (grant no. 164521).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
ScienceDirect
Access this article on ScienceDirectLinked Article
- 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.
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- Test-Retest Reliability of the Neuromuscular Recovery ScaleArchives of Physical Medicine and RehabilitationVol. 96Issue 8
