Development and Rasch Validation of an Observational Assessment Tool of Upper Limb Functional Impairment in Stroke Survivors: Functional Assessment Test for Upper Limb

Gasperini, Giulio; Rota, Matteo; Guanziroli, Eleonora; Bissolotti, Luciano; Balestrieri, F.; Chisari, Carmelo; Currà, Antonio; Felice, Alessandra Del; Farina, Nico; Manganotti, Paolo; Millevolte, Marzia; Restivo, Domenico A.; Santamato, Andrea; Sciarrini, F.; Specchia, Alessandro; Trompetto, Carlo; Calza, Stefano; Molteni, Franco

doi:10.1016/j.apmr.2022.10.003

Cited by 2 publications

(2 citation statements)

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“…This is usually not part of standardized clinical outcome measures since they mainly focus on task accomplishment. Only a few outcome measures are focused on the assessment of quality aspects of functional movements [ 17 ]. Technologies such as wearable sensors, robots, force sensors, and 3D motion-capture techniques allowing the objective measurement of movement kinematics and kinetics were suggested as the best way to tackle this problem [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation

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Guanziroli²,

Brambilla

et al. 2023

Healthcare

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In clinical scenarios, the use of biomedical sensors, devices and multi-parameter assessments is fundamental to provide a comprehensive portrait of patients’ state, in order to adapt and personalize rehabilitation interventions and support clinical decision-making. However, there is a huge gap between the potential of the multidomain techniques available and the limited practical use that is made in the clinical scenario. This paper reviews the current state-of-the-art and provides insights into future directions of multi-domain instrumental approaches in the clinical assessment of patients involved in neuromotor rehabilitation. We also summarize the main achievements and challenges of using multi-domain approaches in the assessment of rehabilitation for various neurological disorders affecting motor functions. Our results showed that multi-domain approaches combine information and measurements from different tools and biological signals, such as kinematics, electromyography (EMG), electroencephalography (EEG), near-infrared spectroscopy (NIRS), and clinical scales, to provide a comprehensive and objective evaluation of patients’ state and recovery. This multi-domain approach permits the progress of research in clinical and rehabilitative practice and the understanding of the pathophysiological changes occurring during and after rehabilitation. We discuss the potential benefits and limitations of multi-domain approaches for clinical decision-making, personalized therapy, and prognosis. We conclude by highlighting the need for more standardized methods, validation studies, and the integration of multi-domain approaches in clinical practice and research.

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Section: Resultsmentioning

confidence: 99%

A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation

Scano

Guanziroli²,

Brambilla

et al. 2023

Healthcare

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“…The Actual Amount of Use Test (AAUT) and the Functional ASsessment Test for Upper Limb (FAST-UL) are observational capacity tests, i.e., spontaneous use of the affected arm during predefined tasks in a predefined setting. Therefore, the AAUT and the FAST-UL also do not reflect spontaneous upper limb use in daily life (20,21).…”

Section: Introductionmentioning

confidence: 99%

Rasch validation of a new scale to measure dependency in arm use in daily life: the Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale

et al. 2023

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IntroductionAbout 77% of adults with stroke have upper limb impairments. Many scales are available to measure the impairment and activity level of the affected limb. However, an observational scale to assess dependency on others in upper limb performance during daily life activities instead of laboratory settings is lacking. Therefore, we developed a new 5-item Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale (UL-LIMOS). As next step in the psychometric analysis, we evaluated the unidimensionality and structural validity of the UL-LIMOS with Rasch Measurement Theory and we calculated a cut-off score for independent arm use in daily life activities at discharge.MethodsThis is a single-center cross-sectional study in adults with (sub) acute stroke. We applied Rasch Measurement Theory (RMT) to analyze the structural validation and unidimensionality of the UL-LIMOS. The outputs provide evidence of unidimensionality, item and person fit, overall fit, differential item functioning (DIF), principal component analysis of residuals (PCAR), person separation reliability (PSR), and residual item correlations (to identify local item dependence). Person mean location, floor and ceiling effects identify proper targeting.ResultsWe recruited 407 adults with (sub) acute stroke (median age 63 years, 157 women). All items and persons fit the Rasch model. The PSR of 0.90 indicates that clinicians and researchers can reliably use the scale for individual decision-making. There were small floor (2.70%) and ceiling (13.00%) effects. The average person mean location was 1.32 ± 2.99 logits. There was no DIF. PCAR eigenvalue was 2.46 with 49.23% explained variance. Paired t-tests revealed that 0.89% of person locations were significantly different, confirming unidimensionality. One pair of items (arm and hand use and fine hand use) showed residual item correlations. The ROC’s AUC was 0.90, CI95% = [0.85–0.96] with cut-off score of ≥14/20, and high sensitivity (87%, CI95% = [81%–91%]), specificity (83%, CI95% = [77%–87%]) for independent arm use in daily living at discharge.DiscussionThe new Rasch-based UL-LIMOS is a valid ICF-based observation performance scale at the ICF-activity level, to evaluate dependency during upper limb use in daily life in adults with stroke. Additional psychometric analyses are warranted. The UL-LIMOS would be a valuable addition to the core assessments of adults with (sub) acute stroke.

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Development and Rasch Validation of an Observational Assessment Tool of Upper Limb Functional Impairment in Stroke Survivors: Functional Assessment Test for Upper Limb

Cited by 2 publications

References 41 publications

A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation

A Narrative Review on Multi-Domain Instrumental Approaches to Evaluate Neuromotor Function in Rehabilitation

Rasch validation of a new scale to measure dependency in arm use in daily life: the Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale

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