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Updated: Feb 20, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke
Gong-Hong Lin1, Yi-Jing Huang1, Shih-Chieh Lee1
1School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Objective:
To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke.
Design:
Simulation study.
Setting:
One rehabilitation unit in a medical center.
Participants:
Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%).
Interventions:
Not applicable.
Main Outcome Measures:
The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index.
Results:
The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88-.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91-.95) and responsiveness (standardized response mean, .65-.76) of the CAT-FAS were good in patients with stroke.
Conclusions:
We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients.
