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The Patient-Specific Functional Scale
The latest here:
Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational StudyJanne Evensen, PT, MSc1*, Helene Lundgaard Soberg, PT, PhD2,3, Unni Sveen. OT, PhD2,3,
Knut A. Hestad, PhD4,5 Jennifer L. Moore, PT, DHS 6 and Berit Arnesveen Bronken RN,
PhD4
1Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik,
Norway
2Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
3Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo,
Norway
4Department of Health- and Nursing Sciences, Faculty of Health- and Social Sciences, The
Inland Norway University of Applied Sciences, Elverum, Norway
5Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
6 Regional Center of Knowledge Translation in Rehabilitation, Sunnaas RehabilitationHospital, Oslo/ Nesodden, Norway
© The Author(s) 2023. Published by Oxford University Press on behalf of the American
Physical Therapy Association.
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*Address all correspondence to Janne Evensen, Department of Physical Medicine and
Rehabilitation, Innlandet Hospital Trust, 2819 Gjøvik, Norway
Email: janne.evensen@sykehuset-innlandet.no
Janne Evensen, ORCID ID: https://orcid.org/0000-0002-3433-8742
Helene Lundgaard Soberg, ORCID ID: https://orcid.org/0000-0001-6908-7480
Unni Sveen, ORCID ID: https://orcid.org/0000-0001-8720-760X
Knut Hestad, ORCID ID: https://orcid.org/0000-0001-6876-9076
Jennifer Moore, ORCID ID: https://orcid.org/0000-0002-6968-0679
Berit Arnesveen Bronken, ORCID ID: https://orcid.org/0000-0002-7954-4814
KEYWORDS: Stroke, Rehabilitation, Goals, Shared Decision Making, Patient-Reported
Outcome Measure, Patient-Specific Functional Scale
Running Head: Measurement Properties of the PSFS: Original Research
TOC Category: Neurology
Original submission: March 22, 2022
Revised submission: August 22, 2022
Accepted: December 5, 2022
Abstract
Objective.
Knut A. Hestad, PhD4,5 Jennifer L. Moore, PT, DHS 6 and Berit Arnesveen Bronken RN,
PhD4
1Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik,
Norway
2Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
3Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo,
Norway
4Department of Health- and Nursing Sciences, Faculty of Health- and Social Sciences, The
Inland Norway University of Applied Sciences, Elverum, Norway
5Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
6 Regional Center of Knowledge Translation in Rehabilitation, Sunnaas RehabilitationHospital, Oslo/ Nesodden, Norway
© The Author(s) 2023. Published by Oxford University Press on behalf of the American
Physical Therapy Association.
Downloaded from https://academic.oup.com/ptj/advance-article/doi/10.1093/ptj/pzad014/7035424 by guest on 16 February 2023UNCORRECTED MANUSCRIPT
2
*Address all correspondence to Janne Evensen, Department of Physical Medicine and
Rehabilitation, Innlandet Hospital Trust, 2819 Gjøvik, Norway
Email: janne.evensen@sykehuset-innlandet.no
Janne Evensen, ORCID ID: https://orcid.org/0000-0002-3433-8742
Helene Lundgaard Soberg, ORCID ID: https://orcid.org/0000-0001-6908-7480
Unni Sveen, ORCID ID: https://orcid.org/0000-0001-8720-760X
Knut Hestad, ORCID ID: https://orcid.org/0000-0001-6876-9076
Jennifer Moore, ORCID ID: https://orcid.org/0000-0002-6968-0679
Berit Arnesveen Bronken, ORCID ID: https://orcid.org/0000-0002-7954-4814
KEYWORDS: Stroke, Rehabilitation, Goals, Shared Decision Making, Patient-Reported
Outcome Measure, Patient-Specific Functional Scale
Running Head: Measurement Properties of the PSFS: Original Research
TOC Category: Neurology
Original submission: March 22, 2022
Revised submission: August 22, 2022
Accepted: December 5, 2022
Abstract
Objective.
This study investigated the validity, reliability, responsiveness, and
interpretability of the Patient Specific Functional Scale (PSFS) in subacute stroke
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interpretability of the Patient Specific Functional Scale (PSFS) in subacute stroke
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rehabilitation to determine its suitability to measure patient-identified rehabilitation goals.
Methods.
A prospective observational study was designed according to the checklist from Consensus-Based Standards for Selecting Health Measurement Instruments(COSMIN). Seventy-one patients diagnosed with stroke were recruited in thesubacute phase from a rehabilitation unit in Norway. The International Classification of Functioning, Disability and Health was used to assess the content validity.
Assessment of construct validity was based on hypotheses for correlation of the PSFS and comparator measurements. We assessed reliability by calculating the ICC(3.1) and the standard error of measurement. The assessment of responsiveness was based on hypotheses for the correlation of change scores between the PSFS and the comparator measurements. A receiver operating characteristic analysis was conducted to assess responsiveness. The smallest detectable change and minimal important change were calculated.
Results. Eighty percent of the PSFS items were classified as activities and participation in the International Classification of Functioning, Disability and Health indicating satisfactory content validity. The reliability was satisfactory with an ICC of 0.81 (95% CI = 0.69–0.89). The standard error of measurement was 0.70 point, and the smallest detectable change was 1.94 points. Five of 7 hypotheses were confirmed for construct validity, and 5 of 6 were confirmed for responsiveness, indicating moderate construct validity and high responsiveness. Assessing responsiveness with a criterion approach resulted in an area under the curve of 0.74. A ceiling effect was identified for 25% of the participants 3 months after discharge. The minimal important change was estimated to be 1.58 points.
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Conclusion.
Assessment of construct validity was based on hypotheses for correlation of the PSFS and comparator measurements. We assessed reliability by calculating the ICC(3.1) and the standard error of measurement. The assessment of responsiveness was based on hypotheses for the correlation of change scores between the PSFS and the comparator measurements. A receiver operating characteristic analysis was conducted to assess responsiveness. The smallest detectable change and minimal important change were calculated.
Results. Eighty percent of the PSFS items were classified as activities and participation in the International Classification of Functioning, Disability and Health indicating satisfactory content validity. The reliability was satisfactory with an ICC of 0.81 (95% CI = 0.69–0.89). The standard error of measurement was 0.70 point, and the smallest detectable change was 1.94 points. Five of 7 hypotheses were confirmed for construct validity, and 5 of 6 were confirmed for responsiveness, indicating moderate construct validity and high responsiveness. Assessing responsiveness with a criterion approach resulted in an area under the curve of 0.74. A ceiling effect was identified for 25% of the participants 3 months after discharge. The minimal important change was estimated to be 1.58 points.
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Conclusion.
This study demonstrates satisfactory measurement properties for the PSFS in individuals undergoing inpatient stroke rehabilitation.
Impact. This study supports the use of the PSFS to document and monitor patient identified rehabilitation goals in patients receiving subacute stroke rehabilitation when applied using a shared decision approach.
Impact. This study supports the use of the PSFS to document and monitor patient identified rehabilitation goals in patients receiving subacute stroke rehabilitation when applied using a shared decision approach.
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