Item Hierarchy-Based Analysis of the Rivermead Mobility Index Resulted in Improved Interpretation and Enabled Faster Scoring in Patients Undergoing Rehabilitation After Stroke

作者：Roorda Leo D^*; Green John R; Houwink Annemieke; Bagley Pam J; Smith Jane; Molenaar Ivo W; Geurts Alexander C

来源：Archives of Physical Medicine and Rehabilitation, 2012, 93(6): 1091-1096.

DOI：10.1016/j.apmr.2011.12.021

• Disability evaluation
• Mobility limitation
• Outcome assessment (health care)
• Psychometrics
• Rehabilitation
• Stroke

Roorda L.D. Green JR, Houwink A, Bagley PJ, Smith J, Molenaar IW, Geurts AC. Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke.. Arch Phys Med Rehabil 2012;93: 1091-6. %26lt;br%26gt;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. %26lt;br%26gt;Design: Cohort study. %26lt;br%26gt;Setting: Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. %26lt;br%26gt;Participants: Item hierarchy of the RMT was studied in an initial group of patients (n=620; mean age +/- SD, 69.2 +/- 12.5; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchy based start-and-stop rules was checked in a second group of patients (n=237; mean age +/- SD, 60.0 +/- 11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. %26lt;br%26gt;Interventions: Not applicable. %26lt;br%26gt;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. %26lt;br%26gt;Results: The RMI. had good fit of the double monotonicity model (coefficient H-T=.87). The interpretation of the total score improved. Item hierarchy based 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. %26lt;br%26gt;Conclusions: Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI.

• 出版日期2012-6