ON THE STRUCTURAL VALIDITY OF BESTEST, MINI-BESTEST AND BRIEF-BESTEST.

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Bibliometric indicators and core journals in physical and rehabilitation medicine.

Background and objective: the concept of the "standing" of scientific journals (in terms of influence, prestige, popular ity, etc.) is multi-dimensional and cannot be captured adequately by a single indicator. The aim of this report is to compare and comment on different bibliometric indicators related to some leading journals in rehabilitation, in order to provide further insights regarding their practical usefulness for Physical and Rehabilitation Medicine. Discussion: The commonly used Journal Impact Factor and the new SCImago Journal Rank indicator are measures of average "impact per paper". Other new measures show potentially useful complementarities with them and warrant further attention. For example, the Eigenfactor score represents a measure of total "citation impact" and seems sufficiently to express the "importance" of a journal. In fact, the information conveyed by the Eigenfactor score corresponds to a general consensus of journal status in Physical and Rehabilitation Medicine, as expressed by the European Consensus Committee on "International Rehabilitation Journals" and captured by a survey among European Physical and Rehabilitation Medicine researchers

Measurement precision of the Pain Catastrophizing Scale and its short forms in chronic low back pain

The Pain Catastrophizing Scale (PCS) is a widely studied tool to assess pain catastrophizing for chronic low back pain (LBP). Short forms of the PCS exist, but their measurement precision at individual level is unclear. This study aimed to analyze the Rasch psychometric characteristics of the PCS and three of its short forms (two 4-item and one 6-item) in a sample of 180 Italian-speaking patients with chronic LBP, and compare their measurement precision at the individual level. We performed a Rasch analysis on each version of the PCS and calculated test information functions (TIFs) to examine conditional measurement precision. Rasch analysis showed appropriate rating category functioning, unidimensionality, and acceptable fit to the Rasch model for all PCS versions. This represented a prerequisite for performing further advanced psychometric analyses. According to TIFs, the PCS full scale showed-at any score level-higher measurement precision in estimating individual pain catastrophizing than its short forms (which had unacceptably high standard errors of measurement). Our results show acceptable conditional precision of the PCS full scale in estimating pain catastrophizing. However, further studies are needed to confirm its diagnostic accuracy at individual level. On the other hand, the study warns against use of the three PCS short forms for clinical decision-making at the individual level

Rasch validation of the prosthetic mobility questionnaire: a new outcome measure for assessing mobility in people with lower limb amputation

Objective: To create a new outcome measure of mobility in people with lower limb amputation, based on a pool of 14 items assessing prosthetic mobility, comprising the 12-item Prosthesis Evaluation Questionnaire (Mobility Section) plus 2 new items. Design: Cross-sectional study. Subjects: A total of 100 subjects (median age 58 years; 46 males; median body mass index 23.8) who had recently undergone lower limb amputation. Methods: Each patient completed the 14-item questionnaire twice: (i) at admission to the rehabilitation unit for prosthetic rehabilitation training; (ii) at 6-month follow-up after discharge. Results: After Rasch analysis, 2 items were deleted (one due to misfit, the other because showing large (> 0.30) positive correlation of residuals with two other items (local dependence). The remaining items fitted the Rasch model (internal construct validity), giving a new 12-item scale with a 5-level response format, the Prosthetic Mobility Questionnaire (PMQ), which demonstrated unidimensionality, lack of differential item functioning, and good reliability indices (person-separation reliability = 0.87; Cronbach's alpha 0.88). Conclusion: Although further studies are needed to increase confidence in clinical use of the PMQ, this new questionnaire appears to be a promising, psychometrically-sound patientreported outcome measure for assessment of mobility in subjects with lower limb amputation who use a prosthesi

Rasch validation of the Activities-specific Balance Confidence Scale and its short versions in patients with Parkinson's disease.

Accepted Jan 10, 2014; Epub ahead of print Mar 28, 2014IntroductIonPostural instability is a key feature of advanced Parkinson's dis-ease (PD) (1), often leading to falls with dramatic consequences (2). Balance impairment can also induce psychological reactions, such as reduced balance confidence and increased fear of fall-ing. Balance confidence (a construct exploring fall-related self-efficacy) and fear of falling may be protective if they interfere only with hazardous activity and increase caution in performing daily living tasks. On the other hand, they can be maladaptive if their effect is to restrict mobility, independence and social par -ticipation, leading to further deconditioning, functional decline and poorer quality of life (3). Therefore, balance confidence is a construct that needs to be clearly understood, accurately meas-ured, and requires timely, appropriate management within fall risk assessment and fall prevention programmes (4).Balance confidence is often analysed with the Activities-specific Balance Confidence scale (ABC) (5), which has been shown to have sound psychometric properties in older adults (5, 6) and people with lower-limb amputations (7, 8) and stroke (9). In subjects with PD, the ABC has only recently been validated (10), by means of a Classical Test Theory approach, while the short versions of ABC proposed for PD (11–13) have undergone only preliminary validation.However, the Classical Test Theory approach does not take into account some standard criteria and attributes (concerning both single items and total score) that need to be considered when evaluating the measurement properties of a tool (14). Rasch analysis is being increasingly recommended in the development and evaluation of clinical tools for healthcare to verify if they comply with the theoretical requirements of measurement, including dimensionality analysis and item-level scale evaluation (15).The aim of this study was to analyse the psychometric prop-erties of the ABC and its 3 short versions in subjects with PD, using both Classical Test Theory and Rasch analysis, in order to determine whether fundamental measurement properties are satisfied and to provide insights into the optimal use of these questionnaires. METHOD