Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS)

Winckel, Ann Van de; Ottiger, Beatrice; Bohlhalter, Stephan; Nyffeler, Thomas; Vanbellingen, Tim

doi:10.1016/j.apmr.2019.02.012

Cited by 12 publications

(17 citation statements)

References 28 publications

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“…The content of our final scale is similar to the subscale of motor, communication, and cognition in Van de Winckel et al ( 14 ). However, there are differences in the item selection between the Lucerne ICF-based multidisciplinary observation scale (LIMOS) and our scale.…”

Section: Discussionmentioning

confidence: 94%

“…Rasch modeling has long been used as an ICF study approach. It was an ideal theoretical model for estimating ordered questionnaires ( 9 , 11 , 12 , 14 ) for transforming the ordinal scale into the linear interval scale. In addition, both personal ability and item difficulty can be calculated in a Rasch model ( 14 ).…”

Section: Discussionmentioning

confidence: 99%

“…It was an ideal theoretical model for estimating ordered questionnaires ( 9 , 11 , 12 , 14 ) for transforming the ordinal scale into the linear interval scale. In addition, both personal ability and item difficulty can be calculated in a Rasch model ( 14 ). MSA was performed as the preliminary screening of the scale content.…”

Section: Discussionmentioning

confidence: 99%

“…To measure personal ability and to quantitatively differentiate item difficulties, scholars introduced the item response theory (IRT) and utilized its parametric method of Rasch modeling in several ICF studies, namely, the brief ICF core set ( 9 , 10 ), rehabilitation set ( 11 ), spinal cord injury core set ( 12 , 13 ), and Lucerne ICF-based multidisciplinary observation scale ( 14 ). However, these models did not solve the problem of efficiency.…”

Section: Introductionmentioning

confidence: 99%

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Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling

et al. 2022

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PurposeThis study aims to accomplish two tasks for International Classification of Functioning, Disability and Health (ICF) application among persons with stroke: (1) to make an ICF tool for measuring personal abilities with simplified assessment operations; (2) to quantitatively evaluate ICF categories for being functioning rather than being disabled.MethodsA total of 130 inpatients with stroke via convenience sampling were evaluated by the extended comprehensive ICF core set for stroke, modified Rankin scale, and modified Barthel index (MBI). This study investigated the responses to 118 stroke-related ICF items (59 items in b and d domains individually) using Mokken scale analysis followed with Rasch modeling.ResultsA Mokken scale with 47 items was extracted from the binary data (1 as no-impairment or mild-impairment and 0 as moderate to complete impairment). A Rasch model with 45 items was derived from the Mokken scale. The conversion chart was available involving the original ordinal scores to Rasch-transformed scores from 0 to 100 (interval scale). Total scores exhibited a high correlation with the personal abilities estimated by the Rasch model. The personal ability also demonstrated a significantly strong correlation with the score of the MBI. Thus, the 45 ICF items were suggested to rate potential functional ability as a single measurement.ConclusionBased on simple “functioning or disabled” judgment tasks, ICF assessment can be simplified to a questionnaire with answering “yes-or-no” questions for each category. Functioning level for each person and difficulty of being functioning for each category can be estimated by the Rasch model of this questionnaire.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling

et al. 2022

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“…RMT can therefore be used to verify whether the items fit the probabilistic mathematical Rasch model. With this analysis, the scale is transformed from an ordinal to an interval measurement which improves instrument precision [57][58][59][60][61][62][63]. Structural validity and unidimensionality are evaluated through the overall fit of the scale, the item and person fit, threshold order of scoring categories within each item, person separation reliability (PSR), targeting, floor and ceiling effects, mean error variance, principal components analysis of residuals (PCAR), and local item dependence (LID) with residual correlations [59,60].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Rasch analysis of the Multidimensional Assessment of Interoceptive Awareness in adults with stroke

Blackwood

Carpentier

Deng

et al. 2022

Preprint

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Purpose The Multidimensional Assessment of Interoceptive Awareness (MAIA) measures interoceptive body awareness, which includes aspects such as attention regulation, self-regulation, and body listening. Our purpose was to validate the MAIA in adults with stroke using Rasch Measurement Theory. Methods The original MAIA has 32 items grouped into eight separately scored subscales that measure aspects of body awareness. Using Rasch Measurement Theory, we evaluated the unidimensionality of the entire scale and investigated person and item fit, person separation reliability, targeting, local item dependence, and principal components analysis of residuals. Results Forty-one adults with chronic stroke (average 3.8 years post-stroke, 13 women, and average age, 57+/-13 years) participated in the study. Overall fit (X2=62.26, p=0.26) and item fit were obtained after deleting 3 items and rescoring 26 items. One participant did not fit the model (2.44%). There were no floor (0.00%) or ceiling effects (0.00%). Local item dependence was found in 42 pairs. The person separation reliability was 0.91, and the person mean location was 0.06+/-1.12 logits. Conclusions The MAIA demonstrated good targeting and reliability, as well as good item and person fit in adults with chronic stroke. A study with a larger sample size is needed to validate our findings.

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Research Paradigm of the International Classification of Functioning, Disability and Health (ICF) With Item Response Theory: Clarification, Classification, and Challenge

Feng,

Liu,

Zhou

et al. 2025

Physiotherapy Res Intl

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BackgroundThe International Classification of Functioning, Disability and Health (ICF) is the worldwide terminology system for measuring health and disability at both individual and population levels. However, the underlying challenges remain in achieving widespread adoption and implementation of ICF within healthcare contexts, including the unequal interval scale of the ICF Likert‐type qualifier system ranging from 0 to 4, a lack of consensus on conceptualization and grading criteria of ICF items, and an excessive number of ICF items associated with each disease. The utilization of item response theory (IRT) for ICF studies demonstrated potential benefits in addressing these issues. Here, a review attempted to provide clarification of two predominant needs (sufficiency and efficiency) and two dimensions of scoring principles (stratification and assignment principles) in the ICF.MethodsA literature search was conducted on the PubMed database, and 44 relative articles were selected. On this basis, this review was undertaken to track the research progress of the ICF based on the parameter IRT method, typically the Rasch model.ResultsThis review outlined the classification of Item response model (IRM) for ICF studies and summarized existing IRT‐based ICF research paradigms. Moreover, this review identified blind spots regarding assignment principles and the difficulty parameter in current ICF‐based IRT studies. The Mokken scale analysis (MSA), as a non‐parametric IRT method, was introduced as a data shaping tool for parametric IRM. The pipeline of the ICF‐based MSA‐Rasch modeling might advance the understanding of ICF clinical application and shed light on a new paradigm of questionnaire design.ConclusionThe advent of ICF‐oriented IRM algorithms may advance the comprehension of ICF clinical application and pave the way for a new paradigm for IRT‐derived ICF questionnaires, namely the parsimonious ICF core set. Additionally, the Wright map holds promise in facilitating insight into rehabilitation trajectories and personalizing rehabilitation goals.

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Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS)

Cited by 12 publications

References 28 publications

Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling

Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling

Preliminary Rasch analysis of the Multidimensional Assessment of Interoceptive Awareness in adults with stroke

Research Paradigm of the International Classification of Functioning, Disability and Health (ICF) With Item Response Theory: Clarification, Classification, and Challenge

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