Table_1_Simplified Post-stroke Functioning Assessment Based on ICF via Dichotomous Mokken Scale Analysis and Rasch Modeling.docx

PurposeThis study aims to accomplish two tasks for International Classification of Functioning, Disability and Health (ICF) application among persons with stroke: (1) to make an ICF tool for measuring personal abilities with simplified assessment operations; (2) to quantitatively evaluate ICF categories for being functioning rather than being disabled.MethodsA total of 130 inpatients with stroke via convenience sampling were evaluated by the extended comprehensive ICF core set for stroke, modified Rankin scale, and modified Barthel index (MBI). This study investigated the responses to 118 stroke-related ICF items (59 items in b and d domains individually) using Mokken scale analysis followed with Rasch modeling.ResultsA Mokken scale with 47 items was extracted from the binary data (1 as no-impairment or mild-impairment and 0 as moderate to complete impairment). A Rasch model with 45 items was derived from the Mokken scale. The conversion chart was available involving the original ordinal scores to Rasch-transformed scores from 0 to 100 (interval scale). Total scores exhibited a high correlation with the personal abilities estimated by the Rasch model. The personal ability also demonstrated a significantly strong correlation with the score of the MBI. Thus, the 45 ICF items were suggested to rate potential functional ability as a single measurement.ConclusionBased on simple “functioning or disabled” judgment tasks, ICF assessment can be simplified to a questionnaire with answering “yes-or-no” questions for each category. Functioning level for each person and difficulty of being functioning for each category can be estimated by the Rasch model of this questionnaire.

本项研究旨在针对中风患者，针对国际功能、残疾与健康分类（ICF）的应用，实现两项任务：（1）开发一套简化评估操作的ICF工具，以衡量个人能力；（2）对ICF类别进行定量评估，以确定其功能状态而非残疾状态。研究方法：通过对130名通过便利抽样选取的中风住院患者进行评估，包括扩展的综合性ICF核心集（针对中风）、改良Rankin量表和改良Barthel指数（MBI）。本研究通过Mokken量表分析，对118项与中风相关的ICF项目（分别有b和d领域的59个项目）进行了调查，随后应用Rasch模型。研究结果：从二元数据（1表示无障碍或轻度障碍，0表示中度至完全障碍）中提取了一个包含47个项目的Mokken量表。由Mokken量表派生出了一个包含45个项目的Rasch模型。转换图表提供了将原始序数值转换为0至100（等距量表）的Rasch转换分数。总分与Rasch模型估计的个人能力高度相关。个人能力也与MBI评分显示出显著且强的相关性。因此，建议将45个ICF项目作为一个单一测量指标来评估潜在的功能能力。结论：基于简单的“功能或残疾”判断任务，ICF评估可以简化为一个只需对每个类别回答“是或否”问题的问卷。通过该问卷的Rasch模型，可以估算每个人的功能水平和每个类别实现功能状态的难度。