Cross-cultural validity of the ABILOCO questionnaire for individuals with stroke, based on Rasch analysis

Abstract

Purpose: The purpose of this study was to evaluate the cross-cultural validity of the Brazilian version of the ABILOCO questionnaire for stroke subjects.

Materials and methods: Cross-cultural adaptation of the original English version of the ABILOCO to the Brazilian–Portuguese language followed standardized procedures. The adapted version was administered to 136 stroke subjects and its measurement properties were assessed using Rash analysis. Cross-cultural validity was based on cultural invariance analyses.

Results: Goodness-of-fit analysis revealed one misfitting item. The principal component analysis of the residuals showed that the first dimension explained 45% of the variance in locomotion ability; however, the eigenvalue was 1.92. The ABILOCO-Brazil divided the sample into two levels of ability and the items into about seven levels of difficulty. The item-person map showed some ceiling effect. Cultural invariance analyses revealed that although there were differences in the item calibrations between the ABILOCO-original and ABILOCO-Brazil, they did not impact the measures of locomotion ability.

Conclusions: The ABILOCO-Brazil demonstrated satisfactory measurement properties to be used within both clinical and research contexts in Brazil, as well cross-cultural validity to be used in international/multicentric studies. However, the presence of ceiling effect suggests that it may not be appropriate for the assessment of individuals with high levels of locomotion ability.

Implications for rehabilitation

• Self-report measures of locomotion ability are clinically important, since they describe the abilities of the individuals within real life contexts.

• The ABILOCO questionnaire, specific for stroke survivors, demonstrated satisfactory measurement properties, but may not be most appropriate to assess individuals with high levels of locomotion ability

• The results of the cross-cultural validity showed that the ABILOCO-Original and the ABILOCO-Brazil calibrations may be used interchangeable.

Keywords:

• Stroke
• locomotion ability
• cross-cultural adaptation
• validity
• Rasch analysis

Disclosure statement

We certify that no party having a direct interest in the results of the research supporting this article has or will confer a benefit on us or any other associated organization.

Additional information

Funding

This research was supported by the Brazilian Funding Agencies: CNPq [grant No. 304434/2014-0] and FAPEMIG [grant No. 00015-14].