The Upper Extremity Functional Index: Reliability and Validity in Patients with Chronic Obstructive Pulmonary Disease

Abstract

The aim of the current study was to examine the psychometric properties of the upper extremity functional index (UEFI) in patients with chronic obstructive pulmonary disease (COPD). Seventy patients with stable COPD completed the UEFI and St. George Respiratory Questionnaire (SGRQ) and performed lung function tests in the first testing session. They completed the UEFI and the Global Rating of Change Scale in the second session, which was within ten days of the first session. The UEFI floor and ceiling effects, internal consistency, test–retest reliability, measurement error, and construct validity were examined. The UEFI was found to have no floor and ceiling effects. The UEFI was also found to have an excellent internal consistency (Cronbach’s alpha = 0.955) and an excellent test–retest reliability (ICC2,1 = 0.91). Totals of 4.85 points and 11.32 points represent the scale’s standard error of measurement, and a minimal detectable change at 90% confidence was used. The UEFI scores showed a significant correlation with the SGRQ activity domain (r = −0.66, p < 0.001) and differed significantly between participants with severe disease and those with mild disease (p = 0.03). The UEFI had no floor or ceiling issues, an excellent internal consistency, a good test–retest reliability, and an acceptable measurement error. The UEFI also demonstrated evidence supporting its construct validity as a measure of upper extremity-related activity limitations in patients with COPD.

Structural Validity of the Arabic Upper Extremity Functional Index Using Exploratory and Confirmatory Factor Analysis

“…The overall score for the UEFI ranges from 0 (reflecting the worst upper extremity function) to 80 (indicating the best upper extremity function). Previous research studies have established the construct validity, reliability, and responsiveness of the Arabic version of the UEFI utilized in the current study in patients with upper extremity musculoskeletal disorders (Aljathlani et al, 2022;Alnahdi, 2023).…”

“…The adapted Arabic UEFI was simple and understandable to Arabic-speaking patients with upper extremity musculoskeletal disorders. Prior studies have examined the measurement properties of the Arabic UEFI in individuals with upper extremity musculoskeletal disorders and also in individuals with chronic obstructive pulmonary disease (Alnahdi and Albarrati, 2021;Aljathlani et al, 2022;Alnahdi, 2023). These prior reports suggested that the Arabic UEFI has excellent internal consistency with homogenous items, test-retest reliability, reasonable measurement error, and substantiating evidence for its construct validity and responsiveness as a tool for assessing upper extremity function.…”

Responsiveness of the Arabic Upper Extremity Functional Index in Patients with Upper Extremity Musculoskeletal Disorders

“…The UEFI has been adapted into the Arabic language and its measurement properties were tested in patients with upper extremity musculoskeletal disorders and also in patients with chronic obstructive pulmonary disease [13,14]. The Arabic UEFI demonstrated excellent internal consistency, test-retest reliability, an acceptable measurement error and evidence supporting its validity as a measure of upper extremity function [13,14].…”