Physical Therapy Korea (한국전문물리치료학회지)

Korean Research Society of Physical Therapy (한국전문물리치료학회)
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A Comparative Study of Item Difficulty Hierarchy of Self-Reported Activity Measure Versus Metabolic Equivalent of Tasks

  • Choi, Bong-Sam (Dept. of Physical Therapy, College of Health and Welfare, Woosong University)
  • Received : 2013.07.24
  • Accepted : 2013.08.27
  • Published : 2013.09.17
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Abstract

The purposes of this study were: 1) to show the item difficulty hierarchy of walking/moving construct of the International Classification of Functioning, Disability and Health-Activity Measure (ICF-AM), 2) to evaluate the item-level psychometrics for model fit, 3) to describe the relevant physical activity defined by level of activity intensity expressed as Metabolic Equivalent of Tasks (MET), and 4) to explore what extent the empirical activity hierarchy of the ICF-AM is linked to the conceptual model based on the level of energy expenditure described as MET. One hundred and eight participants with lower extremity impairments were examined for the present study. A newly created activity measure, the ICF-AM using an item response theory (IRT) model and computer adaptive testing (CAT) method, has a construct on walking/moving construct. Based on the ICF category of walking and moving, the instrument comprised items corresponding to: walking short distances, walking long distances, walking on different surfaces, walking around objects, climbing, and running. The item difficulty hierarchy was created using Winstep software for 20 items. The Rasch analyses (1-parameter IRT model) were performed on participants with lower extremity injuries who completed the paper and pencil version of walking/moving construct of the ICF-AM. The classification of physical activity can also be performed by the use of METs that is often preferred to determine the level of physical activity. The empirical item hierarchy of walking, climbing, running activities of the ICF-AM instrument was similar to the conceptual activity hierarchy based on the METs. The empirically derived item difficulty hierarchy of the ICF-AM may be useful in developing MET-based activity measure questionnaires. In addition to convenience of applying items to questionnaires, implications of the finding could lead to the use of CAT method without sacrificing the objectivity of physiologic measures.

Keywords

References

  1. Ainsworth BE. How do I measure physical activity in my patients? Questionnaires and objective methods. Br J Sports Med. 2009;43(1):6-9.
  2. Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 compendium of physical activities: A second update of codes and met values. Med Sci Sports Exerc. 2011;43(8):1575-1581. https://doi.org/10.1249/MSS.0b013e31821ece12
  3. Balady GJ. Survival of the fittest--more evidence. N Engl J Med. 2002;346(11):852-854. https://doi.org/10.1056/NEJM200203143461111
  4. Bassett DR, Cureton AL, Ainsworth BE. Measurement of daily walking distance-questionnaire versus pedometer. Med Sci Sports Exerc. 2000;32(5):1018-1023.
  5. Berlin JE, Storti KL, Brach JS. Using activity monitors to measure physical activity in free-living conditions. Phys Ther. 2006;86(8):1137-1145.
  6. Blair SN, Haskell WL, Ho P, et al. Assessment of habitual physical activity by a seven-day recall in a community survey and controlled experiments. Am J Epidemiol. 1985;122(5):794-804. https://doi.org/10.1093/oxfordjournals.aje.a114163
  7. Bond TG, Fox CM. Applying the Rasch Model, Fundamental measurement in the human sciences. 2nd ed. Mahwah, NJ, Lawrence Erlbaum Associates Publishers, 2001:158-172.
  8. Brown TA. Confirmatory factor analysis of the penn state worry questionnaire: Multiple factors or method effects? Behav Res Ther. 2003;41(12): 1411-1426. https://doi.org/10.1016/S0005-7967(03)00059-7
  9. Brown TA. Confirmatory factor analysis for applied research. 2008:65-73.
  10. Byrne NM, Hills AP, Hunter GR, et al. Metabolic equivalent: One size does not fit all. J Appl Physiol. 2005;99(3):1112-1119. https://doi.org/10.1152/japplphysiol.00023.2004
  11. Cattell RB. The scree test for the number of factors. Mutivariate Behav Res. 1996;1(2):245-276.
  12. Child D. The Essentials of Factor Analysis. 3rd ed. New York, Continuum, 2006:45-47.
  13. Craig CL, Marshall AL, Sjostrom M, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
  14. Freedson PS, Brendley K, Ainsworth BE, et al. New techniques and issues in assessing walking behavior and its contexts. Med Sci Sports Exerc. 2008;40(7 Suppl):S574-S583. https://doi.org/10.1249/MSS.0b013e31817c71e7
  15. Hambleton RK. Emergence of item response modeling in instrument development and data analysis. Med Care. 2000;38(9 Suppl):II60-II65.
  16. Institute for Objective Measurement Inc.. Correlations: point-biserial, point-measure, residual [Internet]. Chicago, 2005 [cited 2013 July 30]. Available from: http://www.winsteps.com/winman/index.htm? correlations.htm. Correlations: Point-biserial, point-measure, residual.
  17. Point-biserial, point-measure, residual. Pereira MA, FitzerGerald SJ, Gregg EW, et al. A collection of physical activity questionnaires for health-related research. Med Sci Sports Exerc. 1997;29(6 suppl):S1-S205.
  18. Kriska AM, Caspersen CJ. Introduction to a collection of physical activity questionnaires. Med Sci Sports Exerc. 1997;29(6):5-9.
  19. Kriska AM, Sandler RB, Cauley JA, et al. The assessment of historical physical activity and its relation to adult bone parameters. Am J Epidemiol. 1988;127(5):1053-1063. https://doi.org/10.1093/oxfordjournals.aje.a114881
  20. Liang MH, Lew RA, Stucki G, et al. Measuring clinically important changes with patient-oriented questionnaires. Med Care. 2002;40(4 Suppl): II45-II51.
  21. Institute for Objective Measurement Inc.. What do infit and outfit, mean-square and standardized mean? [Internet]. Chicago, 2002 [cited 2013 July 30]. Available from: http://www.rasch.org/rmt/rmt162f.htm. What do infit and outfit, mean-square and standardized mean?.
  22. Linacre JM. Winsteps Rasch Measurement Computer Program. Chicago, IL, winsteps.com, 2005:13-14.
  23. Norman GR, Steiner, D.L. Biostatistics: The bare essentials. St. Louise, MO, Mosby Yearbook Inc., 1994:125-128.
  24. Paffenbarger RS, Jr., Wing AL, Hyde RT. Physical activity as an index of heart attack risk in college alumni. Am J Epidemiol. 1978;108(3): 161-175. https://doi.org/10.1093/oxfordjournals.aje.a112608
  25. Reckase MD. The difficulty of test items that measure more than one ability. Appl Psychol Meas. 1985;9(4):401-412. https://doi.org/10.1177/014662168500900409
  26. Sabari JS, Lim AL, Velozo CA, et al. Assessing arm and hand function after stroke: A validity test of the hierarchical scoring system used in the motor assessment scale for stroke. Arch Phys Med Rehabil. 2005;86(8):1609-1615. https://doi.org/10.1016/j.apmr.2004.12.028
  27. Taylor-Piliae RE, Haskell WL, Iribarren C, et al. Clinical utility of the stanford brief activity survey in men and women with early-onset coronary artery disease. J Cardiopulm Rehabil. 2007;27(4):227-232. https://doi.org/10.1097/01.HCR.0000281768.97899.bb
  28. Velozo CA, Wang Y, Lehman L, et al. Utilizing rasch measurement models to develop a computer adaptive self-report of walking, climbing, and running. Disabil Rehabil. 2008;30(6):458-467. https://doi.org/10.1080/09638280701617317
  29. Wang WC, Chen, CT. Item parameter recovery, standard error estimates, and fit statistics of the winsteps program for the family of rasch models. Educ Psychol Meas. 2005;65:376-404. https://doi.org/10.1177/0013164404268673
  30. Ware JE Jr. A 12-item short-form health survey: Construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3): 220-233. https://doi.org/10.1097/00005650-199603000-00003
  31. Ware JE Jr, Sherbourne CD. The mos 36-item short-form health survey (sf-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473-483. https://doi.org/10.1097/00005650-199206000-00002
  32. Wright BD, Linacre JM. Observations are always ordinal; measurements, however, must be interval. Arch Phys Med Rehabil. 1989;70(12):857-860.
  33. Wright BD, Linacre JM. Reasonable mean-square fit values. Rasch Meas Transac. 1994;8:370.
  34. Wright BD, Masters GN. Rating Scale Analysis. Chicago, IL, MESA Press, 1982:94-101.