Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke

Gong Hong Lin, Yi Jing Huang, Shih Chieh Lee, Sheau Ling Huang, Ching Lin Hsieh

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Objective: To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke. Design: Simulation study. Setting: One rehabilitation unit in a medical center. Participants: Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%). Interventions: Not applicable. Main Outcome Measures: The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index. Results: The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88–.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91–.95) and responsiveness (standardized response mean,.65–.76) of the CAT-FAS were good in patients with stroke. Conclusions: We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients.

Original languageEnglish
Pages (from-to)676-683
Number of pages8
JournalArchives of Physical Medicine and Rehabilitation
Issue number4
Publication statusPublished - Apr 2018
Externally publishedYes


  • Psychometrics
  • Rehabilitation
  • Reproducibility of results
  • Stroke
  • Validation studies as topic

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation


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