Dimensionality and construct validity of the fugl-meyer assessment of the upper extremity
Dimensionality and construct validity of the fugl-meyer assessment of the upper extremity
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DOI：
10.1016/j.apmr.2007.02.036
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发表时间：
2007-06-01
影响因子：
4.3
通讯作者：
Lai, Sue-Min
中科院分区：
文献类型：
--
作者：
Woodbury, Michelle L.;Velozo, Craig A.;Lai, Sue-Min
目的：采用Rasch分析探讨上肢Fugl-Meyer评估的维度和结构效度。设计：对来自2个现有数据集的汇总数据进行二次分析：一个随机治疗性运动临床试验和一个卒中恢复的队列纵向研究。设置：大学研究中心。参与者：共5 12名受试者，年龄69.8 +/- 11.1岁，0至145天poststroke.Interventions：Not applicable.Main Outcome Measures：用主成分分析和Rasch项目拟合统计检查了强迫症。Rasch衍生的项目层次结构进行了检查的一致性与中风后上肢恢复的反射层次概念模型的基础assessment.Results建议的预期过程：因素负荷和项目不适合统计表明，3反射项目经验断开其他评估项目。反射项目被删除。修改后的30项评估显示了一维结构。结论：静息反射测试项目可能会影响测验的维度。除去反射项目，评估是意志运动的一维测量。Rasch生成的项目难度顺序挑战了该工具底层概念框架所暗示的分层结构。
Objective: To investigate the dimensionality and construct Validity of the Fugl-Meyer Assessment of the upper extremity by using Rasch analysis.Design: Secondary analysis of pooled data from 2 existing datasets: a randomized therapeutic exercise clinical trial and a cohort longitudinal study of stroke recovery.Setting: University research center.Participants: A total of 5 12 subjects, ages 69.8 +/- 11.1 years, who were 0 to 145 days poststroke.Interventions: Not applicable.Main Outcome Measures: Dimensionality was examined with principal components analysis and Rasch item-fit statistics. The Rasch-derived item hierarchy was examined for consistency With the expected course of poststroke upper-extremity recovery suggested by the reflex-hierarchical conceptual model underlying the assessment.Results: Factor loadings and item infit statistics suggested that the 3 reflex items were empirically disconnected from other assessment items. The reflex items were removed. The modified 30-item assessment showed a unidimensional structure. The Rasch-item-difficulty order was not consistent with the expected item order.Conclusions: The items testing resting-state reflexes may flu-eaten the assessment's dimensionality. With reflex items removed, the assessment is a unidimensional measure of volitional movement. The Rasch-generated item-difficulty order challenges the hierarchical structure implied by the instrument's underlying conceptual framework.