Item HierarchyaBased Analysis of the Rivermead Mobility Index Resulted in Improved Interpretation and Enabled Faster Scoring in Patients Undergoing Rehabilitation After Stroke
Roorda LD, Green JR, Houwink A, Bagley PJ, Smith J, Molenaar IW, Geurts AC. Item hierarchyabased analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke. Objective: To enable improved interpretation of...
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Veröffentlicht in: | Archives of physical medicine and rehabilitation 2012-06, Vol.93 (6), p.1091-1096 |
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Sprache: | eng |
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Zusammenfassung: | Roorda LD, Green JR, Houwink A, Bagley PJ, Smith J, Molenaar IW, Geurts AC. Item hierarchyabased analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke. Objective: To enable improved interpretation of the total score and faster scoring of the Rivermead Mobility Index (RMI) by studying item ordering or hierarchy and formulating start-and-stop rules in patients after stroke. Design: Cohort study. Setting: Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. Participants: Item hierarchy of the RMI was studied in an initial group of patients (n=620; mean age-SD, 69.2 plus or minus 12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchyabased start-and-stop rules was checked in a second group of patients (n=237; mean age-SD, 60.0 plus or minus 11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. Interventions: Not applicable. Main Outcome Measures: Mokken scale analysis was used to investigate the fit of the double monotonicity model, indicating hierarchical item ordering. The percentages of patients with a difference between the RMI total score and the scores based on the start-and-stop rules were calculated to check the adequacy of these rules. Results: The RMI had good fit of the double monotonicity model (coefficient HT=.87). The interpretation of the total score improved. Item hierarchyabased start-and-stop rules were formulated. The percentages of patients with a difference between the RMI total score and the score based on the recommended start-and-stop rules were 3% and 5%, respectively. Ten of the original 15 items had to be scored after applying the start-and-stop rules. Conclusions: Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI. |
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ISSN: | 0003-9993 |
DOI: | 10.1016/j.apmr.2011.12.021 |