The Rasch analysis was made using RUMM2030 software. A significance value of 0. 05 was used throughout, and Bonferroni correction was applied to adjust for the multiple numbers of tests. Results Trichostatin A mw The median age of the total sample of 150 patients was 76 years. There were 86 men. One hundred thirty eight of the patients had ischemic stroke, while the remaining 12 patients had haemorrhagic stroke. The SwePASS assessments were made at a median of 5 days after stroke onset. Inhibitors,Modulators,Libraries According to the Likelihood Ratio test, SwePASS did not meet the requirements of a rating scale model. Thus, the Partial Credit Model, a polytomous version of the Rasch analysis was used. Discussion At this initial Inhibitors,Modulators,Libraries validation stage, the Rasch analysis provided evidence that SwePASS did not work as originally intended.
On the basis of these initial findings, the scale was modified. After adjustments of categories and local dependencies, Inhibitors,Modulators,Libraries this first Rasch analysis of the SwePASS indicates that the SwePASS could be considered as unidimensional and that it works as a global measure of postural control as the ability to body stabilization during every day activities at an individual level in patients with stroke, regardless of gender, age and location of stroke lesion. At the same time, the initial analysis highlighted a number of potential problems. For instance, 4 of 12 items showed disordered thresholds. From a clinical perspective this is unsatisfactory, both for the patient and for the physiotherapist, who must be able to trust the results of the measurement instrument.
Particularly, it is important for a physiotherapist to know that a scale has sound measurement properties based on items that reflect the hypothesized structure and hierarchy of the construct. An improvement in ability or a good ability shall give a higher or a high score, while deterioration in ability Inhibitors,Modulators,Libraries or a low ability Inhibitors,Modulators,Libraries must give lower or a low score. Using a scale with disordered thresholds, a change in categories will be difficult or even impossible to evaluate. A misjudge of a patients postural control may have consequences on the patients self efficacy and to safety. Disordered thresholds, which may result from several different factors, are likely caused by the item designer as a failure of the hypothesis behind the items. Counter intuitive, this was addressed by re scoring according to statistical criteria as well as to clinical judgement.
For instance, in Item 4, raters may find it difficult to discriminate between the two first categories, as the word slight may be too selleck chem inhibitor vague despite the extended explanation, thus leading to disordered thresholds. The new created observational framework of 3 categories for this item may be discriminated more easily by the physiotherapist. In Item 7, the category 3 does not seem to add much information of postural control. Furthermore, in Item 8.