Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling

Area of Science:

• Rehabilitation Medicine
• Health Informatics
• Psychometrics

Background:

• Stroke significantly impacts personal functioning and quality of life.
• Current assessment tools for stroke-related disability can be complex.
• The International Classification of Functioning, Disability and Health (ICF) provides a standardized framework for describing health and disability.

Purpose of the Study:

• To develop a simplified ICF-based tool for measuring personal abilities in stroke survivors.
• To quantitatively evaluate ICF categories for their utility in distinguishing between functioning and disability.
• To create a user-friendly ICF assessment with simplified operations.

Main Methods:

• Evaluated 130 stroke inpatients using the extended ICF core set for stroke, modified Rankin scale, and modified Barthel index (MBI).
• Applied Mokken scale analysis and Rasch modeling to 118 stroke-related ICF items.
• Derived a 45-item Rasch model from a 47-item Mokken scale.

Main Results:

• A 45-item ICF scale was developed, correlating highly with personal abilities estimated by the Rasch model.
• The personal ability scores showed a strong correlation with the MBI scores.
• The derived ICF items can rate potential functional ability as a single measurement.

Conclusions:

• ICF assessment for stroke can be simplified into a yes/no questionnaire.
• The Rasch model can estimate individual functioning levels and category difficulty.
• This approach facilitates a more straightforward evaluation of functioning versus disability.