The Upper Limb Functional Index: development and determination of reliability, validity, and responsiveness
C Philip Gabel1, Lori A Michener, Brendan Burkett
1Virginia Commonwealth University, Medical College of Virginia, Richmond, USA. cp.gabel@bigpond.com
Summary
The new Upper Limb Functional Index (ULFI) is a reliable and valid tool for assessing upper limb function. It offers superior clinical utility and practical characteristics compared to existing measures.
Area of Science:
- Orthopedics
- Rehabilitation Medicine
- Health Outcomes Research
Background:
- Existing upper limb outcome measures face criticism for clinical utility issues.
- These include length, scoring time, missing responses, and psychometric limitations.
Purpose of the Study:
- Develop a new upper limb outcome measure, the Upper Limb Functional Index (ULFI).
- Evaluate the ULFI's reliability, validity, and responsiveness in a prospective study.
Main Methods:
- Patients (n=214) completed the ULFI concurrently with DASH and UEFS scales.
- Test-retest reliability (n=46) and responsiveness (n=29) were assessed in subgroups.
- Internal consistency, change scores, and practical characteristics were analyzed.
Main Results:
- ULFI demonstrated strong correlation with DASH (r=0.85) and UEFS (r=0.78).
- Excellent test-retest reliability (ICC=0.96) and internal consistency (Cronbach's alpha=0.89).
- ULFI showed high responsiveness (SRM=1.87, ES=1.28), minimal missing responses, and completion/scoring time under 3 minutes.
Conclusions:
- The ULFI possesses sound psychometric properties and practical characteristics.
- It is a viable and preferred clinical outcome tool for upper limb status and impairment.
- ULFI offers superior clinical utility and efficiency without item redundancy.
