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Validity and Reliability of the Activity Card Sort 3 in Persons With Thumb Carpometacarpal Osteoarthritis
Corey W McGee1,2, Triet Lu2,3, Jagur Justen1
1Translational Musculoskeletal and Occupational Performance Research Laboratory, Department of Occupational Therapy, College of Pharmacy, University of Minnesota, Minneapolis, Minnesota, USA.
Abstract:
ImportanceAlthough individuals with thumb carpometacarpal (CMC1) osteoarthritis (OA) commonly experience participation restrictions, participation-focused outcome measures remain underinvestigated, and clinicians primarily rely on assessments of impairments in body structures and functions.ObjectiveTo determine the concurrent validity, test-retest reliability, and precision of the Activity Card Sort 3 (ACS3) in individuals with nonoperative CMC1 OA.DesignSingle-cohort observational psychometric study with repeated measures over a 2-week interval.SettingRemote assessments conducted via videoconferencing.ParticipantsThirty-three adults with radiographically confirmed CMC1 OA completed two virtual assessments approximately 2 weeks apart.Outcomes and MeasuresConcurrent validity was examined by comparing ACS3 domain and total scores with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). Test-retest reliability of the "current," "previous," and "% retained" activities scores was evaluated using intraclass correlation coefficients (ICC3,1). Precision was assessed using the standard error of measurement and minimal detectable change.ResultsThe ACS3 demonstrated good concurrent validity through strong associations with conceptually related WHODAS 2.0 domains. "Current" and "% retained" scores demonstrated good-to-excellent test-retest reliability across all domains. "Current" scores consistently showed the highest reliability and precision. "Previous" scores demonstrated lower reliability and greater measurement error, suggesting recall bias. Carrying forward "previous" scores from session 1 to session 2 improved the reliability of "% retained" scores.Conclusions and RelevanceThe ACS3 is a valid and reliable measure of participation for individuals with nonoperative CMC1 OA. The "current" and "% retained" scores may support occupational therapy practitioners in conducting participation-focused assessment of persons with CMC1 OA.
