Measurement properties of performance-based instruments to assess mental function during activity and participation in traumatic brain injury: A systematic review

Abstract

Background: Performance-based measures that focus primarily on the ability to engage in ADL are routinely used by occupational therapists to assess a client’s cognitive abilities.

Objective: To perform a systematic review to investigate measurement properties of performance-based instruments to assess mental function during activity and participation in individuals with traumatic brain injury.

Material and methods: Pubmed, EMBASE, CINAHL, PsycINFO and OTseeker were searched. The Consensus-based Standards for the selection of health measurement instruments checklist was used to evaluate methodological quality of each included study. The quality criteria adapted by Terwee were applied to extract the results of each measurement property followed by a best evidence synthesis.

Results: Twenty-eight articles, including 40 ratings of measurement properties, were included. The combination of the Functional Independence Measure and the Functional Assessment Measure showed moderate evidence of good internal consistency (Cronbach’s alpha 0.99), but conflicting evidence of reliability (ICC 0.83) and poor evidence of construct validity. All other instruments showed limited or unknown evidence.

Conclusions: This review provides an overview of measurement properties of performance-based instruments and contributes to such methodological considerations before choosing an instrument. Though, the results reveal a lack of high-quality evidence for any of the measurement properties, it is recommended to use tools with the highest possible evidence for positive ratings.

Significance: This review contributes with psychometric evidence on instruments to use in occupational therapy practice and research.

Keywords:

• Brain injury
• cognitive impairment
• psychometric properties
• ecological validity
• validity
• reliability
• rehabilitation

Acknowledgements

The authors thank health science librarian Maria Oesterbye, who assisted the development of the detailed search strategy.

Disclosure statement

The authors of this review have no conflicts of interests. This systematic review did not require ethical approval.

Additional information

Funding

The review was initiated and funded by the Department of Physiotherapy and Occupational Therapy, Aarhus University Hospital, Denmark and Neurorehabilitation Skive, Hammel Neurorehabilitation Centre and University Research Clinic, Skive, Denmark.