ObjectiveTo develop a patient reported outcome measure (PROM) of active and passive function in the paretic lower limb.
MethodsPotential items for inclusion were identified through a) systematic review and analysis of existing measures and b) analysis of the primary goals for treatment in a spasticity service. Item reduction was achieved through consultation with a purposively-selected group of experienced physiotherapists and occupational therapists (n=16) in a 2-round Delphi process. This was followed by review of Delphi consultation findings by the Project Advisory Group (PAG) consisting of patients and carers.
Results
Development of the LegA included two rounds of Delphi consultation. Further roundswere not required due to the high degree (80%) of agreement between respondents in rounds one and two. From an initial shortlist of 126 items, 29 items were initially identified for inclusion in LegA, and subsequently refined to a 24-item (two sub-scales) tool consisting of 9 passive function sub-scale items and 15 active function sub-scale items. The Delphi consultation ensured content validity, due to the experience of the clinicians in this area of practice and therefore appropriate reduction of items. In common with previous work in the upper limb, a 5-point ordinal scaling structure was chosen, with ratings based on activity over the preceding 7 days.
ConclusionsThe LegA is designed to measure passive and active function following focal interventions for the paretic lower limb. Content and face validity have initially been Development of the Leg Activity Measure (LegA) 3 addressed within the development process. The next phase of development will involve formal evaluation of psychometric properties.
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