Content » Vol 39, Issue 2

Original report

Cross-diagnostic validity of the SF-36 physical functioning scale in patients with stroke, multiple sclerosis and amyotrophic lateral sclerosis: A study using rasch analysis

Annet J. Dallmeijer, Vincent de Groot, Leo D. Roorda, Vera P. M. Schepers, Eline Lindeman, Leonard H. van den Berg, Anita Beelen, Joost Dekker on behalf of the FuPro study group
DOI: 10.2340/16501977-0024


Objective: The aim of this study was to investigate uni­dimensionality and differential item functioning of the SF-36 physical functioning scale (PF10) in patients with various neurological disorders.
Patients: Patients post-stroke (n = 198), with multiple sclero­sis (n = 151) and amyotrophic lateral sclerosis (n = 193) partici­pated.
Methods: Unidimensionality of the PF10 within the patient groups was investigated by performing a separate Rasch analysis for each group. Differential item functioning was investigated in a pooled Rasch analysis of the 3 groups.
Results: Within each group, all items fitted the Rasch model, except the “bathing/dressing” item in the amyotrophic lateral sclerosis group. The pooled analysis showed inadequate fit to the Rasch model for one item (“walking several hundred metres”). Of the other 9 fitting items, 5 showed differential item functioning for stroke vs multiple sclerosis and amyotrophic lateral sclerosis, while no differential item function­ing was found between multiple sclerosis and amyotrophic lateral sclerosis.
Conclusion: All items of the PF10, except one for the amyotrophic lateral sclerosis group, form a unidimensional scale, supporting the use of a sum score as a measure of physical func­tioning within these diagnostic groups. When comparing the data of patients after stroke, with that of patients with multip­le sclerosis and/or amyotrophic lateral sclerosis patients, adjustments for differential item functioning are required.

Lay Abstract


Do you want to comment on this paper? The comments will show up here and if appropriate the comments will also separately be forwarded to the authors. You need to login/create an account to comment on articles. Click here to login/create an account.