Article

Reliable and valid outcome measures are needed to be able to evaluate
recovery, effects of rehabilitation interventions, and changes over time. The ABILHAND Questionnaire is a measure of a patient's self-reported ability to
perform complex daily activities involving use of the hand. This instrument is
commonly used in stroke rehabilitation settings, but data about the measurement
variability are missing.
OBJECTIVE: To assess the test-retest reliability of the
ABILHAND Questionnaire in persons with chronic stroke and to define limits for
the smallest change that indicates a real change, both for a group of individuals
and for a single individual. DESIGN: A test-retest reliability study. SETTINGS:
University hospital. PARTICIPANTS: A convenience sample of 43 persons (11 women
and 32 men; mean age 64 years) with mild to moderate impairments of hand function
6-48 months after sustaining a stroke. INTERVENTION: Not applicable. MAIN OUTCOME
MEASUREMENTS: The ABILHAND Questionnaire is Rasch analyzed, enabling ordinal data
to be converted into an interval scale (logits) and the use of parametric
statistical analyses. The participants responded to 23 items in the ABILHAND
Questionnaire on 2 occasions, 2 weeks apart. Reliability was assessed with the
intraclass correlation coefficient (ICC22.1), the mean difference between the
test sessions (d) together with the 95% confidence intervals for d, the standard
error of measurement (SEM and SEM%), the smallest real difference (SRD and SRD%),
and a Bland and Altman graph. RESULTS: Four outliers with high mean logit scores
(>4.0) were identified in the sample. The results therefore are presented both
for the entire sample (n = 43) and without the 4 outliers (n = 39). The
test-retest agreement was high: ICC2,1 = 0.85 (n = 43) and 0.91 (n = 39). The
SEM%, which represents the smallest change that indicates a real improvement for
a group of individuals, was 21% (n = 43) and 15% (n = 39). The SRD%, which
represents the smallest change that indicates a real clinical improvement for a
single individual, was 59% (n = 43) and 42% (n = 39), respectively. CONCLUSION:
The ABILHAND Questionnaire is reliable in persons with chronic stroke and can be
recommended to evaluate recovery, rehabilitation interventions, and changes over
time in a group of individuals but is less suitable for a single individual.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS