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.
Keywords
List of abbreviations:
BADL (basic activities of daily living), BI (Barthel Index), CAT (computerized adaptive testing), CI (confidence interval), FAS (Functional Assessment of Stroke), FMA (Fugl-Meyer Assessment), LE (lower extremity), LRI (limited reliability increase), PASS (Postural Assessment Scale for Stroke Patients), SRM (standardized response mean), UE (upper extremity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: October 14, 2017
Footnotes
Supported by the Ministry of Science and Technology in Taiwan (grant nos. 106-2811-B-002-036).
Disclosures: none.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
