| Affiliation: | 1. School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan;2. Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan;3. Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taichung, Taiwan |
| Abstract: | ObjectiveTo 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.DesignSimulation study.SettingOne rehabilitation unit in a medical center.ParticipantsPatients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%).InterventionsNot applicable.Main Outcome MeasuresThe UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index.ResultsThe 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.ConclusionsWe 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. |
