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Rasch validation of the Prosthetic Mobility Questionnaire: A new outcome measure for assessing mobility in people
Franco Franchignoni1, Marco Monticone, Andrea Giordano
1, Scientific Institute of Veruno, Salvatore Maugeri Foundation, Via Revislate 13, IT-28010 Veruno (NO), Italy.
Objective:
To create a new outcome measure of mobility in people with lower limb amputation, based on a pool of 14 items assessing prosthetic mobility, comprising the 12-item Prosthesis Evaluation Questionnaire (Mobility Section) plus 2 new items.
Design:
Cross-sectional study.
Subjects:
A total of 100 subjects (median age 58 years; 46 males; median body mass index 23.8) who had recently undergone lower limb amputation.
Methods:
Each patient completed the 14-item questionnaire twice: (i) at admission to the rehabilitation unit for prosthetic rehabilitation training; (ii) at 6-month follow-up after discharge.
Results:
After Rasch analysis, 2 items were deleted (one due to misfit, the other because showing large (> 0.30) positive correlation of residuals with two other items (local dependence). The remaining items fitted the Rasch model (internal construct validity), giving a new 12-item scale with a 5-level response format, the Prosthetic Mobility Questionnaire (PMQ), which demonstrated unidimensionality, lack of differential item functioning, and good reliability indices (person-separation reliability = 0.87; Cronbach's alpha 0.88).
Conclusion:
Although further studies are needed to increase confidence in clinical use of the PMQ, this new questionnaire appears to be a promising, psychometrically-sound patient-reported outcome measure for assessment of mobility in subjects with lower limb amputation who use a prosthesis.
