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Title: Rasch Analysis of the Upper-Limb Sub-scale of the STREAM Tool in an Acute Stroke Population
Authors: Mateen, B
Baker, K
Playford, ED
Keywords: Psychometrics;Stroke;Patient Outcome Assessment;Upper Extremity;Neurological Rehabilitation
Issue Date: 2018
Citation: Topics in Stroke Rehabilitation
Abstract: Background – Stroke is a leading cause of disability worldwide. The most common impairment resulting from stroke is upper limb weakness. Objectives - To determine the usefulness and psychometric validity of the upper limb sub-scale of the STREAM in an acute stroke population. Methods: Rasch Analysis, including unidimensionality assumption testing, determining model fit, and analysis of: reliability, residual correlations, & differential item functioning. Results - 125 individuals were assessed using the upper limb sub-scale of the Stroke Rehabilitation Assessment of Movement (STREAM) tool. Rasch analysis suggests the STREAM is a unidimensional measure. However, when scored using the originally proposed method (0-2), or using the response pattern (0-5) neither variant fit the Rasch model (p < 0.05). Although, the reliability was good (Person-Separation Index – 0.847 & 0.903 respectively). Correcting for the disordered thresholds, and thereby producing the new scoring pattern, led to substantial improvement in the overall fit (chi-square probability of fit - 22%), however, the reliability was slightly reduced (PSI – 0.806). Conclusions - The study proposes a new scoring method for the upper limb sub-scale of the STREAM outcome measure in the acute stroke population.
ISSN: 1074-9357
Appears in Collections:Dept of Clinical Sciences Embargoed Research Papers

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