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Preliminary Psychometric Evaluation of the Brachial Assessment Tool Part 2: Construct Validity and Responsiveness

Published:December 13, 2017DOI:https://doi.org/10.1016/j.apmr.2017.11.004

      Abstract

      Objectives

      To evaluate construct validity and responsiveness of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for people with traumatic brachial plexus injury (BPI), and to compare it to the Disabilities of the Arm, Shoulder and Hand (DASH) and the Upper Extremity Functional Index (UEFI).

      Design

      Cross-sectional study.

      Setting

      Outpatient clinics.

      Participants

      Adults (N=29; age range, 20–69y) with confirmed traumatic BPI.

      Interventions

      Participants completed the BrAT 3 times over an 18-month period together with 16 DASH activity items and the UEFI. Evaluations were undertaken of construct validity, known-groups validity, 1-way repeated analysis of variance, and effect size.

      Main Outcome Measures

      BrAT, DASH, and UEFI.

      Results

      The BrAT demonstrated a moderate to low correlation with the DASH activity items (<0.7) and a large correlation with the UEFI (>0.7). According to known-groups validity, only the BrAT was able to discriminate between people who stated they could use their hand versus those who were unable to use their hand to perform activities. All measures indicated a significant effect for time with the exception of BrAT subscale 1. The effect size was highest for the BrAT but lower than expected (BrAT, .52–.40; DASH, .15; UEFI, .36).

      Conclusions

      These preliminary findings support the BrAT as a valid and responsive patient-reported outcome measure for adults with traumatic BPI. The BrAT activity items appear to be more targeted than the DASH or UEFI particularly for people with more severe BPI. The BrAT also appears to be measuring a different activity construct than the DASH and the UEFI. Further work is required to confirm these results with larger sample sizes.

      Keywords

      List of abbreviations:

      BPI (brachial plexus injury), BrAT (Brachial Assessment Tool), DASH (Disabilities of the Arm, Shoulder and Hand), GPUS (Global Perceived Use Scale), ICF (International Classification of Functioning, Disability and Health), UEFI (Upper Extremity Functional Index)
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