Article

The purpose of this study was to determine
whether Rasch analysis supports the UEFI as a measure of a single construct (ie,
upper extremity function) and whether a Rasch-validated UEFI has adequate
reproducibility for individual-level patient evaluation. DESIGN: This was a
secondary analysis of data from a repeated-measures study designed to evaluate
the measurement properties of the UEFI over a 3-week period. METHODS: Patients
(n=239) with musculoskeletal upper extremity disorders were recruited from 17
physical therapy clinics across 4 Canadian provinces. Rasch analysis of the UEFI
measurement properties was performed. If the UEFI did not fit the Rasch model,
misfitting patients were deleted, items with poor response structure were
corrected, and misfitting items and redundant items were deleted. The impact of
differential item functioning on the ability estimate of patients was
investigated. RESULTS: A 15-item modified UEFI was derived to achieve fit to the
Rasch model where the total score was supported as a measure of upper extremity
function only. The resultant UEFI-15 interval-level scale (0-100, worst to best
state) demonstrated excellent internal consistency (person separation index=0.94)
and test-retest reliability (intraclass correlation coefficient [2,1]=.95). The
minimal detectable change at the 90% confidence interval was 8.1. LIMITATIONS:
Patients who were ambidextrous or bilaterally affected were excluded to allow for
the analysis of differential item functioning due to limb involvement and arm
dominance. CONCLUSION: Rasch analysis did not support the validity of the 20-item
UEFI. However, the UEFI-15 was a valid and reliable interval-level measure of a
single dimension: upper extremity function. Rasch analysis supports using the
UEFI-15 in physical therapist practice to quantify upper extremity function in
patients with musculoskeletal disorders of the upper extremity.

Langue : ANGLAIS