Measuring disability and function in older women: psychometric properties of the late-life function and disability instrument. Performance-Based Versus Patient-Reported Physical Function: What Are the Underlying Predictors? Creating a computer adaptive test version of the late-life function and disability instrument. Psychometric comparisons of the timed up and go, one-leg stand, functional reach, and Tinetti balance measures in community-dwelling older people. Psychometric Comparisons of 4 Measures for Assessing Upper-Extremity Function in People With Stroke Assessing mobility in older adults: the UAB Study of Aging Life-Space Assessment. Relationships between upper-limb functional limitation and self-reported disability 3 months after stroke. Responsiveness of mobility, daily living, and instrumental activities of daily living outcome measures for geriatric rehabilitation. The Amyotrophic Lateral Sclerosis Functional Rating Scale. Assessment of activities of daily living in patients with amyotrophic lateral sclerosis. The ALS CNTF treatment study (ACTS) phase I-II Study Group. Psychometric properties of the sensory scale of the Fugl-Meyer Assessment in stroke patients Measuring change in disability after inpatient rehabilitation: comparison of the responsiveness of the Barthel Index and the Functional Independence Measure Development and validation of a physical performance instrument for the functionally impaired elderly: the Physical Disability Index (PDI). Hand-grip strength predicts incident disability in non-disabled older men. Psychometric properties of instruments to measure the quality of end-of-life care and dying for long-term care residents with dementia Validation and use of performance measures of functioning in a non-disabled older population: MacArthur studies of successful aging Which questionnaire? A psychometric evaluation of three patient-based outcome measures used to assess surgery for stress urinary incontinence. A psychometric validation of two brief measures to assess palliative need in patients severely affected by multiple sclerosis.
BACKGROUND The recent development of the Late-Life Function and Disability Instrument ( LL-FDI ) was an important contribution to the measurement of function and disability in older adults . The present study examined the psychometric properties and construct validity of the LL-FDI measure in a sample of older women . METHODS Older black ( n = 81 ) and white ( n = 168 ) women completed the LL-FDI  , several measures of physical function , and physical activity measures , and had their body mass index assessed at baseline of an ongoing prospect i ve study . Confirmatory factor analyses ( CFA ) and correlational analyses were used to examine factorial and construct validity of the measure . RESULTS The CFA , using an iterative model modification technique , result ed in an acceptable 15-item solution for the function component and an 8-item solution for the disability component . This abbreviated instrument demonstrated high correlations with the original scales . Construct validity for the LL-FDI was supported . Participants who demonstrated better physical function , reported being more active , and had lower body mass index reported less disability and less difficulty with function on the LL-FDI . CONCLUSIONS The LL-FDI appears to be an effective instrument for assessing function and disability in older women , and the abbreviated version reported here may prove useful in certain circumstances due to its brevity . However , continued determination of the construct validity of the complete and abbreviated scales is recommended Background Functional limitations have been operationally defined for studies of rehabilitation science through measures of physical performance and patient-reported function . Although conceived as representing similar concepts , differences between these 2 modes of measuring physical functioning have not been adequately characterized scientifically . Objective The purpose of this study was to compare the Short Physical Performance Battery ( SPPB ) with the function component of the Late-Life Function and Disability Instrument ( LLFDI ) with respect to their association with physiologic factors and other psychosocial and health factors potentially influencing rehabilitative care . Design This study was a cross-sectional analysis of baseline data from a sample of community-dwelling older adults ( N=137 ) with mobility limitations enrolled in a r and omized controlled trial of exercise . Methods A performance-based measure of function ( the SPPB ) and a self-report measure of function ( the LLFDI ) served as functional outcomes . Physiologic factors included measures of leg strength , leg velocity , and exercise tolerance test ( ETT ) duration , which served as a surrogate measure of aerobic capacity . Psychosocial and health factors included age , sex , height , body mass index , number of chronic conditions , depression , and falls efficacy . Results Separate multivariable regression models predicting SPPB and LLFDI scores described 33 % and 42 % of the variance in each outcome ( R2 ) , respectively . Leg velocity and ETT duration were positively associated with both performance-based and patient-reported functional measures . Leg strength and age were positively associated with SPPB scores , whereas number of chronic conditions , sex , and falls efficacy were associated with the LLFDI scores . Limitations This study included older adults with mobility limitations and may not generalize to other population s. Conclusions Performance-based and patient-reported measures of physical function appear to assess different aspects of an older person 's functioning . The SPPB was associated with age and physiologic factors , whereas patient-reported function measured by the LLFDI was associated with these factors as well as with psychosocial and health factors BACKGROUND This study applied item response theory ( IRT ) and computer adaptive testing ( CAT ) method ologies to develop a prototype function and disability assessment instrument for use in aging research . Herein , we report on the development of the CAT version of the Late-Life Function and Disability Instrument ( Late-Life FDI ) and evaluate its psychometric properties . METHODS We used confirmatory factor analysis , IRT methods , validation , and computer simulation analyses of data collected from 671 older adults residing in residential care facilities . We compared accuracy , precision , and sensitivity to change of scores from CAT versions of two Late-Life FDI scales with scores from the fixed-form instrument . Score estimates from the prototype CAT versus the original instrument were compared in a sample of 40 older adults . RESULTS Distinct function and disability domains were identified within the Late-Life FDI item bank and used to construct two prototype CAT scales . Using retrospective data , scores from computer simulations of the prototype CAT scales were highly correlated with scores from the original instrument . The results of computer simulation , accuracy , precision , and sensitivity to change of the CATs closely approximated those of the fixed-form scales , especially for the 10- or 15-item CAT versions . In the prospect i ve study , each CAT was administered in <3 minutes and  CAT scores were highly correlated with scores generated from the original instrument . CONCLUSIONS CAT scores of the Late-Life FDI were highly comparable to those obtained from the full-length instrument with a small loss in accuracy , precision , and sensitivity to change OBJECTIVES To compare the practicality , reliability , validity , and responsiveness of the timed up and go ( TUG ) , one-leg st and ( OLS ) , functional reach ( FR ) , and Tinetti balance ( TB ) performance measures in people aged 65 and older . DESIGN A prospect i ve study . SETTING Shin-Sher Township of Taichung County , west- central Taiwan . PARTICIPANTS Twelve hundred community-dwelling older people . MEASUREMENTS During an initial assessment at their residences , participants were interviewed for demographics , cognition , fall history , use of a walking aid , and activities of daily living ( ADLs )  , in addition to completing the four balance tests . Falls were ascertained by telephone every 3 months for a 1-year follow-up ; the four balance measures and ADLs were also reassessed at the end of the follow-up year . RESULTS Of the four balance measures , the OLS had the lowest participation rate , and participation of people who were cognitively impaired had fallen in the previous year , used a walking aid , or suffered from an ADL disability was lower than for their counterparts . The time to complete the tests ranged from 58 seconds for OLS , to 160 seconds for the TB . All four balance measures exhibited excellent test-retest reliability and discriminant validity but poor responsiveness to fall status . The TB showed better discriminant , convergent , and predictive validities and responsiveness to ADL changes than the other three tests . CONCLUSION According to psychometric properties , the most suitable performance measure for evaluating balance in community-dwelling older people was the TB , followed by the TUG Background : Functional limitation of the upper extremities is common in patients with stroke . An upper-extremity measure with sound psychometric properties is indispensable for clinical and research use . Objective : The purpose of this study was to compare the psychometric properties of 4 clinical measures for assessing upper-extremity motor function in people with stroke : the upper-extremity subscale of the Fugl-Meyer Motor Test ( UE-FM ) , the upper-extremity subscale of the Stroke Rehabilitation Assessment of Movement , the Action Research Arm Test ( ARAT ) , and the Wolf Motor Function Test . Design : This was a prospect i ve , longitudinal study . Methods : Fifty-three people with stroke were evaluated with the 4 measures at 4 time points ( 14 , 30 , 90 , and 180 days after stroke ) . Thirty-five participants completed all of the assessment s. The ceiling and floor effects , validity ( concurrent validity and predictive validity ) , and responsiveness of each measure were examined . Interrater reliability and test-retest reliability also were examined . Results : All measures , except for the UE-FM , had significant floor effects or ceiling effects at one or more time points . The Spearman ρ correlation coefficient for each pair of the 4 measures was ≥.81 , indicating high concurrent validity . The predictive validity of the 4 measures was satisfactory ( Spearman ρ , ≥.51 ) . The responsiveness of the 4 measures at 14 to 180 days after stroke was moderate ( .52 ≤ effect size ≤ .79 ) . The 4 measures had good interrater reliability ( intraclass correlation coefficient [ ICC ] , ≥.92 ) and test-retest reliability ( ICC , ≥.97 ) . Only the minimal detectable changes of the UE-FM ( 8 % of the highest possible score ) and the ARAT ( 6 % ) were satisfactory . Limitations : The sample size was too small to conduct data analysis according to type or severity of stroke . In addition , the timed component of the Wolf Motor Function Test was not used in this study . Conclusions : All 4 measures showed sufficient validity , responsiveness , and reliability in participants with stroke . The UE-FM for assessing impairment and the ARAT for assessing disability had satisfactory minimal detectable changes , supporting their utility in clinical setting BACKGROUND AND PURPOSE The University of Alabama at Birmingham ( UAB ) Study of Aging Life-Space Assessment ( LSA ) is a relatively new instrument to measure mobility . The purpose of this report is to describe the relationships between LSA and traditional measures of physical function , sociodemographic characteristics , depression , and cognitive status . SUBJECTS Subjects were a stratified r and om sample of 998 Medicare beneficiaries aged > or = 65 years . The sample was 50 % African American , 50 % male , and 50 % from rural ( versus urban ) counties . METHODS In-home interviews were conducted . Mobility was measured using the LSA , which documents where and how often subjects  travel and any assistance needed during the 4 weeks prior to the assessment . Basic activities of daily living ( ADL ) and instrumental activities of daily living ( IADL ) , cognitive status , income level , presence of depressive symptoms , and transportation re sources were determined . The  Short Physical Performance Battery ( SPPB ) was used to assess physical performance . RESULTS Simple bivariate correlations indicated a significant relationship between LSA and all variables except residence ( rural versus urban ) . In a regression model , physical function ( ADL , IADL ) and physical performance ( SPPB ) accounted for 45.5 % of the variance in LSA scores . An additional 12.7 % of the variance was explained by sociodemographic variables , and less than 1 % was explained by cognition and depressive symptoms . DISCUSSION AND CONCLUSION The LSA can be used to document patients ' mobility within their home and community . The LSA scores are associated with a person 's physical capacity and other factors that may limit mobility . These scores can be used in combination with other tests and measures to generate clinical hypotheses to explain mobility deficits and to plan appropriate interventions to address these deficits This study explored relationships between upper-limb ( UL ) functional limitations and self-reported disability in stroke patients with relatively pure motor hemiparesis who were enrolled in an acute rehabilitation treatment trial . All participants were enrolled in the VECTORS ( Very Early Constraint Treatment for Recovery from Stroke ) study . VECTORS is a single-center pilot clinical trial of early application of constraint-induced movement therapy ( CIMT ) . All 39 subjects who completed 90 days of VECTORS  were included in this analysis . Trained study personnel who were blinded to the treatment type performed all evaluations . Data in this article examine relationships between assessment s performed 90 days after stroke . Functional limitation measures included the Action Research Arm ( ARA ) test and Wolf Motor Function Test ( WMFT ) , and self-reported disability measures included the Functional Independence Measure ( FIM ) and Motor Activity Log ( MAL ) ( by telephone ) . Mean plus or minus st and ard deviation time from stroke onset to r and omization was 9.4 plus or minus 4.3 days , and median time to follow-up was 99 days ( range 68 - 178 ) . Subjects with perfect or near-perfect scores on the ARA test or WMFT reported residual disability on the FIM and MAL . Quality of movement on the WMFT ( functional ability score ) was not strongly associated with self-reported frequency , and speed of movement on the WMFT ( timed score ) was not associated with self-reported frequency ( MAL amount of use ) . In this early UL intervention trial , we found that perceived disability measures captured information that was not assessed by functional limitation and impairment scales . Our results indicate that excellent motor recovery as measured by functional limitation and impairment scales did not equal restoration of everyday productive UL use and speed of task completion did not translate to actual use . Our results confirm the need for a measurement strategy that is sensitive to change , assesses a broad performance range , and detects meaningful clinical improvements in early rehabilitation intervention trials OBJECTIVES To assess and compare the ability of the Timed Up & Go ( TUG ) and subscales of the Functional Autonomy Measurement System ( SMAF ) to detect change in people undergoing geriatric rehabilitation in inpatient geriatric rehabilitation units ( GRUs ) and day hospitals . DESIGN Longitudinal design with repeated measures obtained at admission and discharge from rehabilitation and at 2 follow-up interviews . SETTING Inpatient and outpatient hospital-based setting s. PARTICIPANTS Subjects ( N=237 , age 80+/-7 y ) had data at admission and discharge from rehabilitation ( changing time frame ) , and of these , 160 had data at 2 subsequent follow-ups ( stable time frame ) . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES The TUG was used to estimate basic mobility , and subscales of the SMAF were used to estimate general mobility ( SMAF-mobility ) , basic activities of daily living ( SMAF-ADL ) , and instrumental activities of daily living ( SMAF-IADL ) . Professionals ' perception of change was used as a criterion . RESULTS The TUG generated large values for the st and ardized response mean ( SRM ) and Guyatt 's responsiveness index in GRUs ( .98 and 1.12 ) and day hospitals ( .89 and 1.85 ) . Professionals ' perception of change in mobility was explained by a perceptible change in the TUG in day hospitals ( 15 % ) but not in GRUs . The SMAF-mobility , SMAF-ADL , and SMAF-IADL were associated with large values of SRM and Guyatt 's responsiveness index in GRUs ( .97 - 2.17 ) and with small to moderate values in day hospitals ( .29-.54 ) . Moderate to large portions in the professionals ' perceptions of change for mobility ( 20 % , 17 % ) , basic ADLs ( 10 % and 14 % ) , and IADLs ( 23 % and 19 % ) were associated with the respective change scores of the subscales of the SMAF in both GRUs and day hospitals . CONCLUSIONS Progress of older adults in the areas of mobility , basic ADLs , and IADLs can be captured using the TUG , SMAF-mobility , SMAF-ADL , and SMAF-IADL in both GRUs and day hospitals . The results support their use in setting s of high- and low-intensity rehabilitation , thus suggesting their adequacy for use in these 2 setting OBJECTIVES To test the utility of a new , easy to administer instrument for assessing activities of daily living in patients with amyotrophic lateral sclerosis ( ALS ) , to vali date its accuracy , and to assess its ability to record disease progression in patients with ALS against other functional scales , quantitative isometric muscle testing , and global assessment scales . DESIGN Serial assessment s of patients who presented to four ALS treatment centers in two multicenter studies . PATIENTS Study 1 ( cross-sectional ) evaluated 75 consecutive patients who presented to four ALS treatment centers during a 2-month period . Study 2 ( longitudinal ) evaluated the progression of 53 patients who were enrolled in a multicenter , phase I-II clinical trial of recombinant human ciliary neurotrophic factor for treatment of ALS . OUTCOME MEASURES The ALS Functional Rating Scale ( ALSFRS ) was compared with quantitative myometry and with other measures of daily function in patients with ALS both cross-sectionally and longitudinally . RESULTS The first study of 75 patients evaluated the internal consistency , the test-retest reliability , and the construct validity of the ALSFRS . Internal consistency and test-retest reliability were high . Patient self-rating of upper- and lower-extremity-dependent tasks were highly correlated with measures of upper- and lower-extremity strength , respectively . Thus , the ALSFRS has good construct validity . In the second study , ALSFRS scores declined in t and em with deterioration in motor and pulmonary function , indicating its sensitivity to change . CONCLUSIONS The ALSFRS is a useful instrument for evaluation of functional status and functional change in patients with ALS . Its results are in close agreement with objective measures of muscle strength and pulmonary function . The ALSFRS may be used as a screening measure for entry into clinical trials , as a surrogate measure of function in situations in which muscle strength can not be measured directly , or as an adjunct to myometry Objective : To examine the psychometric properties of the sensory scale of the Fugl-Meyer Assessment ( FMA-S ) in stroke patients with a broad range of neurological and functional impairment at times from 14 to 180 days after stroke . Subjects : A total of 176 first stroke patients consecutively admitted to a university based medical centre . Design : This prospect i ve , longitudinal investigation was based on data collected at 14 , 30 , 90 and 180 days after stroke . Main outcome measures : Reliability ( inter-rater reliability and internal consistency ) , validity ( convergent and predictive validity ) and responsiveness of the FMA-S  were examined . Results : The inter-rater agreement of the total score of the FMA-S was excellent , with an intraclass correlation coefficient of 0.93 . The Cronbach 's alphas of the FMA-S at four time points after stroke ranged from 0.94 to 0.98 , indicating excellent internal consistency . However , the FMA-S showed a significant ceiling effect ( more than 44.4 % of the subjects achieving the highest score ) , poor to moderate inter-rater reliability for light touch items ( weighted kappa ranging from 0.30 to 0.55 ) , low to moderate validity ( Spearman 's rho ranging from 0.29 to 0.53 ) , and low to moderate responsiveness ( st and ardized response mean ranging from 0.27 to 0.67 ) at different post-stroke stages of recovery . Conclusions : The psychometric properties of the FMA-S in measuring sensory function do not support its clinical use in stroke patients . Further studies on methods to improve the psychometric properties of the FMA-S are needed BACKGROUND The importance of evaluating disability outcome measures is well recognised . The Functional Independence Measure ( FIM ) was developed to be a more comprehensive and “ sensitive ” measure of disability than the Barthel Index ( BI ) . Although the FIM is widely used and has been shown to be reliable and valid , there is limited information about its responsiveness , particularly in comparison with the BI . This study compares the appropriateness and responsiveness of these two disability measures in patients with multiple sclerosis and stroke . METHODS Patients with multiple sclerosis ( n=201 ) and poststroke ( n=82 ) patients undergoing inpatient neurorehabilitation  were studied . Admission and discharge scores were generated for the BI and the three scales of the FIM ( total , motor , and cognitive ) . Appropriateness of the measures to the study sample s was determined by examining score distributions , floor and ceiling effects . Responsiveness was determined using an effect size calculation . RESULTS The BI , FIM total , and FIM motor scales show good variability and have small floor and ceiling effects in the study sample s. The FIM cognitive scale showed a notable ceiling effect in patients with multiple sclerosis . Comparable effect sizes were found for the BI , and two FIM scales ( total and motor ) in both patients with multiple sclerosis and stroke patients . CONCLUSION All measures were appropriate to the study sample . The FIM cognitive scale , however , has limited usefulness as an outcome measure in progressive multiple sclerosis . The BI , FIM total , and FIM motor scales show similar responsiveness , suggesting that both the FIM total and FIM motor scales have no advantage over the BI in evaluating change Article describes development of the Physical Disability Index ( PDI ) , an observer-administered , performance-based instrument measuring physical disability in frail-elderly persons without severe cognitive impairment . Sixty-five items in four subscales encompassing Range of Motion ( ROM ) , Strength ( STR ) , Balance ( BAL ) , and Mobility ( MOB ) were measured . Subjects were r and omly selected frail nursing home residents ( N = 103 ) with a Folstein Mini-Mental State Exam ( MMSE ) score of > or = 11 . Using correlation matrices , cluster analysis , and regression techniques , the scale was reduced to 54 items . All individual item values were st and ardized and aggregated into subscale and summary PDI scores , each with a range of 0 - 100 . Test-retest and interrater reliability were evaluated . Discriminant and convergent validity were established using MMSE , Physical Self-Maintenance Scale ( PSMS ) , and Sickness Impact Profile-Physical Dimension ( SIP-PD ) . PDI is a performance-based instrument that appears to discriminate among frail individuals with differing levels of physical function . Further testing is warranted in other population s of frail-elderly persons to ascertain its applicability and generalizability OBJECTIVES To verify if h and -grip performance in older men is a predictor of disability . DESIGN Population -based prospect i ve study . SETTING A sample from the Italian rural cohorts of the FINE study ( Finl and , Italy , Netherl and s Elderly ) , representative of the general population of elderly men surveyed in 1991 and 1995 . PARTICIPANTS 140 men aged 71 - 91 years who reported no disability in performing activities of daily living ( ADLs ) , instrumental activity of daily living ( IADLs ) and mobility activities at baseline examination and provided information on their functional status at follow-up 4 years later . MEASUREMENTS Disability was defined as needing help in performing ADLs , IADLs and mobility . H and -grip strength  was evaluated at baseline by a mechanical dynamometer . RESULTS After adjusting for potential confounding variables , a lower concentration of high-density lipoprotein cholesterol was the only factor predicting disability in men aged 76 years or younger and only reduced h and -grip strength predicted incident disability in men 77 years or older . CONCLUSION Poor h and strength as measured by h and -grip is a predictor of  disability  in older people . The h and -grip test is an easy and inexpensive screening tool to identify elderly people at risk of disability Purpose Quality of care for long-term care ( LTC ) residents with dementia at the end-of-life is often evaluated using st and ardized instruments that were not developed for or thoroughly tested in this population . Given the importance of using appropriate instruments to evaluate the quality of care ( QOC ) and quality of dying ( QOD ) in LTC , we compared the validity and reliability of ten available instruments commonly used for these purpose s. Methods We performed prospect i ve observations and retrospective interviews and surveys of family ( n = 70 ) and professionals ( n = 103 ) of LTC decedents with dementia in the Netherl and s. Results Instruments within the constructs QOC and QOD were highly correlated , and showed moderate to high correlation with overall assessment s of QOC and QOD . Prospect i ve and retrospective ratings using the same instruments differed little . Concordance between family and professional scores was low . Cronbach ’s alpha was mostly adequate . The EOLD – CAD showed good fit with pre-assumed factor structures . The EOLD – SWC and FPCS appear most valid and reliable for measuring QOC , and the EOLD – CAD and MSSE for measuring QOD . The POS performed worst in this population . Conclusions Our comparative study of psychometric properties of instruments allows for informed selection of QOC and QOD measures for LTC residents with dementia Assessment of physical functioning in older persons has generally focused on identifying and characterizing subjects at the disabled end of the functional spectrum . This paper examines the validity of objective , st and ardized performance measures of physical functioning in characterizing the hierarchy of functioning in non-disabled , higher functioning older persons . Data are from 1192 participants aged 70–79 years in The MacArthur Research Network on Successful Aging Field Study . Participants were drawn from three communitybased population s and represented the upper tertile of functioning , based on cognitive and physical screening assessment s. The cohort showed a great deal of heterogeneity on most of the performance measures of functioning that were used . Several analyses provided evidence that this variability was not r and om and that the performance measures were valid measures of functioning in this cohort : 1 ) individual performance measures showed a moderate degree of correlation with each other ; 2 ) a summary measure of performance showed an association with chronic diseases and other factors known to be associated with health status ; and 3 ) a larger group than expected by chance alone was found to be functioning at the very highest level . ( Aging Clin . Exp . Res . 6 : 410 - 419 , 1994 AIMS The aim of the study was to further vali date three patient-based outcome measures ( PBOM ) used to assess the outcome of surgery for stress urinary incontinence and to compare their psychometric properties with a view to determining the most appropriate measure for clinical use . METHODS The work was embedded within a r and omized controlled trial of laparoscopic and open colposuspension . The trial recruited 291 women from six centers . The three instruments compared were Bristol  Female Lower Urinary Tract Symptom Question naire ( BFLUTS )  ,  Kings Health Question naire ( KHQ )  , and the Symptom Severity Index and Symptom Impact Index ( SSI/SII ) . The International Consultation on Incontinence ( ICI ) ABC grading system of psychometric propertie 's reliability , validity , and responsiveness was used to evaluate the instruments . RESULTS From the analysis of the psychometric properties of the three instruments , the SSI/SII appeared to have the best psychometric profile ; Grade A , BFLUTS was of grade A , and KHQ was of grade B. SSI/SII had a good degree of internal consistency ( Cronbach 's alpha 0.74 - 0.78 ) . BFLUTS and KHQ both had domains in which the internal consistency was < 0.7 . The  SSI domain of the SSI/SII was the only domain to correlate to the 1-hr pad test . All domains of the SSI/SII were able to distinguish those cured from not cured and it was most responsive to change . Unlike the KHQ , the SSI/SII had no significant ceiling or floor effects . CONCLUSIONS This study has demonstrated that when instruments are used in different population s their psychometric properties may change . All three instruments analyzed had limitations when used as an outcome measure for surgery for stress urinary incontinence CONTEXT Most patient-reported outcome measurement tools in multiple sclerosis ( MS ) are geared toward less severely affected patients . Palliative care outcome measures have not been vali date d in patients with MS . OBJECTIVES To assess the psychometric properties of the  Core-Palliative Care Outcome Scale ( Core-POS ) and POS-MS-Symptoms ( POS-MS-S ) in patients severely affected by MS . METHODS Secondary analyses were conducted on data from a Phase II trial of palliative care in MS . Patients completed assessment s using the following five scales : Core-POS , POS-MS-S , the Multiple Sclerosis Impact Scale , the United Kingdom Neurological Disability Scale , and the Exp and ed Disability Status Scale . Data quality , scaling assumptions , acceptability , internal consistency , and construct validity of the Core-POS and POS-MS-S were determined using st and ard psychometric methods . RESULTS The 46 participants had a mean ±SD age of 52.8 ±10.6 years . The mean Exp and ed Disability Status Scale score was 7.9 ± 1.2 . Missing data were low ( 0 and 0.2 % for the Core-POS and POS-MS-S , respectively ) , and floor and ceiling effects were absent . Internal consistency was good ( Cronbach 's alpha for the Core-POS and POS-MS-S were 0.72 [ 95 % CI 0.56 - 0.84 ] and 0.81 [ 95 % CI 0.72 - 0.89 ] , respectively ) . Construct validity was consistent with a priori hypotheses 17 of 20 times . CONCLUSION Psychometric analyses confirm that the Core-POS and POS-MS-S are acceptable , reliable , and valid in patients severely affected by MS
High test-retest reliability was found for the Function component , while results for the Disability component were more variable .
Conclusions There is extensive evidence to support the construct validity and sensitivity to change of the LLFDI among various clinical population s of community-dwelling older adults .
Background The choice of measure for use as a primary outcome in geriatric research is contingent upon the construct of interest and evidence for its psychometric properties .
The Late-Life Function and Disability Instrument ( LLFDI ) has been widely used to assess functional limitations and disability in studies with older adults .
The primary aim of this systematic review was to evaluate the current available evidence for the psychometric properties of the LLFDI .