Construct validity, responsiveness, minimal detectable change, and minimal clinically important difference of the stroke self-efficacy questionnaire in individuals receiving stroke rehabilitation.

PURPOSE: To assess the clinimetric properties of the Stroke Self-Efficacy Questionnaire (SSEQ) and estimate the minimal detectable change (MDC) and minimal clinically important difference (MCID) from the database of our randomized controlled trials (RCT) of individuals receiving stroke rehabilitation. METHODS: We retrieved the pre- and post-intervention scores of the SSEQ and Stroke Impact Scale (SIS) from 80 stroke survivors. The analysis of clinimetric properties was performed using: (1) confirmatory factor analysis and item response theory modeling (IRT) for construct validity; (2) standardized response mean and Glass's delta for responsiveness; (3) MDC based on the standard deviation (SD) or standard error of measurement (SEM) of the SSEQ change scores; (4) MCID determined by the external anchor-SIS; (5) conditional MDC (cMDC) derived from the IRT analysis. RESULTS: There was a bi-factorial construct with excellent model-data fit and marked responsiveness. The MDC determined by the SD and SEM were 1.5 and 3.0, respectively, and the MCIDs were 3.3 and 3.7. CONCLUSIONS: This study confirmed that SSEQ is a valid and reliable assessment tool for patients receiving stroke rehabilitation. We also provided practical threshold values, especially demonstrating the benefit of using individualized cMDC, to help clinicians better interpret the change in the SSEQ scores.

This study indicated that the Stroke Self-Efficacy Questionnaire (SSEQ) is reliable and may involve a bi-factor structure.The SSEQ total scale and the activity domain were highly responsive to change.The self-management domain of the SSEQ was moderately responsive.Using conditional minimal detectable change (cMDC) along with MDC may improve the interpretability of treatment change.

The predictive relationships between advanced dynamic balance and physical activity/quality of life in Parkinson's disease.

Gait and balance problems commonly occur in Parkinson's disease (PD). However, balance tasks with only one performance objective (e.g., sit-to-stand) may not be sufficient, compared to dual motor tasks (e.g., carrying a tray while walking), to be applied to the assessments and interventions which are designed to promote PD patients' balance functioning, physical activity (PA) and health-related quality of life (HQoL). The aim of this study, therefore, was to determine whether advanced dynamic balance, measured by a demanding motor-motor dual task, is a significant predictor of PA/HQoL in older adults with and without PD. Participants with (n = 22) and without (n = 23) PD were assessed using the Berg Balance Scale (BBS), the single leg hop and stick series task (SLHS), the Physical Activity Scale for the Elderly (PASE), and the Parkinson's Disease Questionnaire-39 (PDQ39). We calculated the R2 change, namely the incremental validity, between the multiple regression models before and after adding the scores on the BBS/SLHS. While controlling for biological and socioeconomic covariates, competence in the SLHS task provided moderate and large levels of incremental validity to PA (ΔR2 = 0.08, Cohen's f2 = 0.25, p = .035) and HQoL (ΔR2 = 0.13, Cohen's f2 = 0.65, p < .001), respectively. In particular for participants with PD, the SLHS explained significantly more variance in HQoL in relation to psychosocial functioning (ΔR2 = 0.25, Cohen's f2 = 0.42, p = .028) compared to the BBS (p = .296). Assessing advanced dynamic balance by means of a highly demanding dual-task paradigm was not only strongly associated with PA but also covered a wider spectrum of HQoL components. This approach is recommended for use in evaluations and interventions carried out in clinical and research settings in order to promote healthy living.

Association Between Motor Competence and Percentage of Body Fat in Late Childhood: Comparing Proficiency in Fundamental Motor Skills and Advanced Movement Skills.

Background: To solve the problem of a weakening relationship between motor competence and body adiposity from late childhood to adolescence, we defined and utilized advanced movement skills (AMS) characterized by higher biomechanical, physiological, and cognitive processing demands compared with fundamental motor skills (FMS). Methods: As a cross-sectional study, the proficiency in FMS and AMS for participants (43 boys and 45 girls) aged 9-12 years was measured by the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) and Test of Advanced Movement Skills (TAMS), respectively. Density plots and skewness of scoring distributions between assessments were inspected to examine test scalability. We also compared the incremental validity of BOT-2 and TAMS scores in the multiple linear regression models predicting the percentage of body fat (%BF, measured by Tanita BF-689 body scale). Results: The TAMS outcomes produced a more positively/right-skewed scoring distribution with a skewness of 0.09 compared with -0.49 for the BOT-2 scores, indicating a better test discrimination ability. The TAMS total scores were a significant predictor (B = -0.92, p = 0.03) in the model predicting %BF (R2 = 0.39, p < 0.001) and provided a greater degree of incremental validity (f2 = 0.058) compared with the BOT-2 (f2 = 0.018). Conclusions: This study provides supportive evidence that the proficiency in AMS is more appropriate, compared with FMS, at tracking the increasing motor competence and body adiposity in late childhood, which is helpful for motor skills training, physical activity promotion, and overweight/obesity prevention.