Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS)

Van de Winckel, Ann; Ottiger, Beatrice; Bohlhalter, Stephan; Nyffeler, Thomas; Vanbellingen, Tim (2019). Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS). Archives of physical medicine and rehabilitation, 100(12), pp. 2314-2323. Elsevier 10.1016/j.apmr.2019.02.012

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Objective To establish Rasch validation of the Lucerne International Classification of Functioning, Disability and Health (ICF)-based Multidisciplinary Observation Scale (LIMOS) in stroke. LIMOS measures the level of assistance in daily life activities related to motor function, communication, cognition, and domestic life. Rasch Measurement Theory (RMT) transforms an ordinal scale into an interval scale and thus the Rasch-based LIMOS scale captures a more accurate improvement of functional outcomes via Rasch-transformed scores. Design Cross-sectional study design. Setting Neurorehabilitation center, Luzerne, Switzerland. Participants We recruited participants with stroke (N=407; age=63.2±16.0y; n=157 women) through consecutive sampling. Interventions Not applicable. Main Outcome Measures Participants were assessed with LIMOS at admission and discharge of rehabilitation. We used RMT to evaluate overall model fit, response dependency, floor and ceiling effect, reliability, and differential item functioning (DIF) for sex, age, type, and time of stroke on the 4 LIMOS subscales using the Rasch Unidimensional Measurement Model (RUMM) 2030 program. Results The Rasch-based LIMOS subscales fit the Rasch model after reducing and rescoring items: motor (from 20 to 18 items), communication (5 items), cognition (from 15 to 13 items), and domestic life (5 items). There was no floor or ceiling effect. Some artificial DIF was identified. Scoring at discharge was dependent on the scoring responses at admission, which means that without applying a correction factor to the discharge scores, there was an underestimation of change in scores between admission and discharge, ranging from 0.24 to 0.97 logits (10.79%-49.24%) on the different subscales. Conclusions The Rasch-based LIMOS scale is recommended to measure functional outcome in people with acute or chronic stages of ischemic or hemorrhagic stroke.

Item Type:

Journal Article (Original Article)

Division/Institute:

10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research
10 Strategic Research Centers > ARTORG Center for Biomedical Engineering Research > ARTORG Center - Gerontechnology and Rehabilitation

UniBE Contributor:

Bohlhalter, Stephan; Nyffeler, Thomas and Vanbellingen, Tim

Subjects:

500 Science > 570 Life sciences; biology
600 Technology > 610 Medicine & health

ISSN:

0003-9993

Publisher:

Elsevier

Language:

English

Submitter:

Angela Amira Botros

Date Deposited:

25 Jun 2019 15:30

Last Modified:

28 Nov 2019 01:31

Publisher DOI:

10.1016/j.apmr.2019.02.012

PubMed ID:

30928303

BORIS DOI:

10.7892/boris.130360

URI:

https://boris.unibe.ch/id/eprint/130360

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