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Improvement of the Van Lieshout hand function test for tetraplegia using a Rasch analysis
A I F Spooren1, C Arnould, R J E M Smeets
11] Rehabilitation Sciences, Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands [2] Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, Maastricht, The Netherlands.
Spinal Cord
|June 19, 2013
Summary
The Van Lieshout hand function test for tetraplegia short form (VLT-SF) was improved using Rasch analysis. Recoding response categories allows for objective, quantitative measurement of arm-hand function in tetraplegia patients.
Area of Science:
- Rehabilitation medicine
- Clinical assessment tools
- Psychometrics
Background:
- The Van Lieshout hand function test for tetraplegia (VLT) assesses arm-hand function in individuals with tetraplegia.
- While valid, reliable, and responsive, the VLT does not meet all criteria for interval-level measurement.
- The VLT short form (VLT-SF) requires further psychometric refinement for optimal clinical utility.
Purpose of the Study:
- To apply Rasch modeling to the VLT-SF to achieve interval-level measurement properties.
- To verify if the revised VLT-SF meets the criteria for an objective measurement tool.
- To assess the VLT-SF's applicability across different severities of motor lesions in tetraplegia.
Main Methods:
- A cross-sectional study involving 73 tetraplegic patients from eight Dutch rehabilitation centers.
- Rasch analysis (using RUMM2030 software) was performed on VLT-SF data.
- Response categories were examined for order, unidimensionality, reliability, and targeting, with subsequent recoding as necessary.
Main Results:
- Seven of the ten VLT-SF items initially exhibited disordered response categories.
- Recoding the original six response categories into three or four categories resolved these issues.
- Following recoding, all items demonstrated unidimensionality, good person separation (R=0.91), and invariant item difficulty across patient subgroups.
Conclusions:
- Rasch analysis confirmed that the VLT-SF, after recoding response categories, meets the requirements of an objective measure.
- The revised VLT-SF enables quantitative comparison of arm-hand function measurements between patients.
- The improved VLT-SF facilitates objective tracking of patient outcomes over time.
