Walking difficulties are common in neurological and other disorders, as well as among the elderly. There is a need for reliable and valid instruments for measuring walking difficulties in everyday life since existing gait tests are clinician rated and focus on situation specific capacity. The Walk-12G was adapted from the 12-item multiple sclerosis walking scale as a generic patient-reported rating scale for walking difficulties in everyday life. The aim of this study is to examine the psychometric properties of the Walk-12G in people with multiple sclerosis (MS) and Parkinson's disease (PD). The Walk-12G was translated into Swedish and evaluated qualitatively among 25 people with and without various neurological and other conditions. Postal survey (MS, n = 199; PD, n = 189) and clinical (PD, n = 36) data were used to test its psychometric properties. Respondents considered the Walk-12G relevant and easy to use. Mean completion time was 3.5 min. Data completeness was good (<5% missing item responses) and tests of scaling assumptions supported summing item scores to a total score (corrected item-total correlations >0.6). Coefficient alpha and test-retest reliabilities were >0.9, and standard errors of measurement were 2.3-2.8. Construct validity was supported by correlations in accordance with a priori expectations. Results are similar to those with previous Walk-12G versions, indicating that scale adaptation was successful. Data suggest that the Walk-12G meets rating scale criteria for clinical trials, making it a valuable complement to available gait tests. Further studies involving other samples and application of modern psychometric methods are warranted to examine the scale in more detail.
PostprintThis is the accepted version of a paper published in Journal of Pain Symptom and Management. This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Nilsson, M., Bladh, S., Hagell, P. [Year unknown!] Fatigue in Parkinson' s disease: measurement properties of a generic and a condition-specific scale. Methods: Postal survey data (n=150; 47% women; mean age, 70) were Rasch analyzed. Journal of Pain Symptom and ManagementPFS-16 scores were tested according both to the original polytomous and the suggested alternative dichotomized scoring methods. Results:The PFS-16 showed overall Rasch model fit whereas the FACIT-F showed signs of misfit, which probably was due to a sleepiness-related item and mixing of positively/negatively worded items. There was no differential item functioning by disease duration but by fatigue status (greater likelihood of needing to sleep or rest during the day among people classified as non-fatigued) in the PFS-16 and FACIT-F. However, this did not impact total score based estimated person measures. Targeting and reliability (≥0.86) was good, but the dichotomized PFS-16 showed compromised measurement precision.Polytomous and dichotomized PFS-16 and FACIT-F scores identified 6, 3 and 4 statistically distinct sample strata, respectively. Conclusion:We found general support for the measurement properties of both scales.However, polytomous PFS-16 scores exhibited advantages compared to dichotomous PFS-16and FACIT-F scores. Dichotomization of item responses compromises measurement precision and ability to separate people, and should be avoided.3
Objective: To gain a deeper understanding of the content of 4 fear of falling (FOF) rating scales by linking them to the International Classification of Functioning, Disability and Health (ICF). Design:Linking study according to the ICF linking rules.Setting: Not applicable.Patients: Not applicable. Methods:The rating scales were the Falls Efficacy Scale-International (FES-I), the Swedish version of the Falls Efficacy Scale (FES[S]), the Activities-specific Balance Confidence Scale (ABC), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE).The process followed the established and updated linking rules. Three linkers independently identified all meaningful concepts in the rating scales and linked them to the most precise ICF categories. The linkers then discussed their results in order to reach consensus. If consensus was not attained, the linkers pursued the discussions with a fourth person to reach consensus. Main outcome measurements: Not applicable.Results: Most meaningful concepts from the overall questions were linked to the ICF component of body functions. Of the 62 items, all but one meaningful concept were linked to the component of activities and participation. All 4 rating scales covered the chapters of mobility and domestic life and had most linkages to the mobility chapter. Conclusions:The linking process revealed similarities and differences between the 4 FOF rating scales, as well as methodological challenges in linking instruments to the ICF. By providing a content description that allows for a direct comparison of the rating scales, the results may be helpful when choosing an appropriate rating scale assessing FOF in clinical practice and research. A further head-to-head comparison through psychometric analyses is required to recommend appropriate FOF rating scales. Studies are also needed to investigate how the overall question and response categories of a rating scale affect respondents' answers.
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