The development, internal construct and uni-dimensionality of the Tetraplegia Upper Limb Activities Questionnaire, TUAQ. Part 1.

Abstract

This study aims to develop a patient reported outcome measure that focuses on relevant daily activities relying on upper extremity for individuals with tetraplegia. Cross-sectional study. SCI units in two countries. Ninety-nine individuals with C2-C8, AIS A-D tetraplegia, mean age 46 years, 1- 43 years post injury. Thirteen items included in the initial testing were chosen from 708 activity limitations identified by individuals with tetraplegia. Items were pilot tested for wording, response options and relevance for both performance and satisfaction. Items were analysed and reselected using exploratory factor analysis and Rasch analysis for local dependency, dimensionality, differential item functioning (DIF), threshold response and targeting. not applicable. Exploratory factor analysis supported a two-factor solution for both performance and satisfaction. While data fit the Rasch model there was evidence of local dependency and multiple disordered thresholds. Three items were removed due to highinter-item correlation and DIF and the scale rescored to five response options. The remaining 10-items demonstrated fit to the Rasch model, with no local dependency, no multidimensionality, no item or person misfit, and minimal disordered thresholds. Results support the internal construct validity and uni-dimensionality of the Tetraplegia Upper limb Activity Questionnaire (TUAQ), a 10-item, 5 response patient reported outcome measure assessing performance and satisfaction with activities targeted to the upper extremity for individuals with tetraplegia. Further testing is required and ongoing to evaluate reliability and responsiveness of the TUAQ.