This systematic review provides an overview of the outcome measures used to address functioning and disability as they are related to the upper extremity. The results of this study may help clinicians and researchers select the most appropriate outcome measure for their clinical population or research question according to ICF-based content validity, and additional information on the reliability and responsiveness of the measures is provided. Our findings also can provide directions for further research.

Study design: An international cross-sectional study. Objective: To examine the quality of life (QoL) of people with spinal cord injury (SCI) across six countries worldwide, controlling for socio-demographic and lesion-related sample characteristics and using a cross-culturally valid assessment. Methods: Data from 243 persons with SCI from Australia, Brazil, Canada, Israel, South Africa and the United States were analyzed. QoL was measured using five satisfaction items from the World Health Organization Quality of Life Assessment. Cross-culturally valid, Rasch-transformed scores were used for comparison. Results: Analysis of variance showed a significant difference in QoL between countries (F ¼ 3.938; df ¼ 5; P ¼ 0.002). Shorter time since injury, no paid employment and living in Brazil were significant predictors of lower QoL, explaining 13% of variance in linear regression. Using multilevel regression with country as higher-order variable, time since injury and paid employment remained significant predictors and explained 18% of variance in QoL. The intraclass correlation coefficient (0.05) indicates that 5% of the variability can be accounted for by country. Conclusion: This study showed QoL differences between countries that could not be explained by differences in demographic and lesion-related characteristics. Results point to the relevance of reintegration of people with SCI into the workforce. Further international comparative research using larger samples is recommended.

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ObjectiveTo construct a metric of the impact of brain disorders on people’s lives, based on the psychosocial difficulties (PSDs) that are experienced in common across brain disorders.Study DesignPsychometric study using data from a cross-sectional study with a convenience sample of 722 persons with 9 different brain disorders interviewed in four European countries: Italy, Poland, Spain and Finland. Questions addressing 64 PSDs were first reduced based on statistical considerations, patient’s perspective and clinical expertise. Rasch analyses for polytomous data were also applied.SettingIn and outpatient settings.ResultsA valid and reliable metric with 24 items was created. The infit of all questions ranged between 0.7 and 1.3. There were no disordered thresholds. The targeting between item thresholds and persons’ abilities was good and the person-separation index was 0.92. Persons’ abilities were linearly transformed into a more intuitive scale ranging from zero (no PSDs) to 100 (extreme PSDs).ConclusionThe metric, called PARADISE 24, is based on the hypothesis of horizontal epidemiology, which affirms that people with brain disorders commonly experience PSDs. This metric is a useful tool to carry out cardinal comparisons over time of the magnitude of the psychosocial impact of brain disorders and between persons and groups in clinical practice and research.

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The SCIM-SR violates certain assumptions of the Rasch measurement model, as shown by the local dependency and differential item functioning. However, an intermediate solution to achieve fit in 3 out of 4 spinal cord injury sub-groups was found. For the time being, therefore, it advisable to use this approach to compute Rasch-transformed SCIM-SR scores.

The Restrictions and Satisfaction scales of the USER-Participation showed satisfactory metric properties. The Frequency scale showed fewer optimal properties, but nonetheless provides important additional information regarding participation. Conversion tables were performed to transform USER-Participation raw scores into a 0-100 interval scale using Rasch-based ability estimates for use in epidemiological studies.