Adaptação transcultural e avaliação das propriedades de medidas do ABILOCO - Brasil: um instrumento de avaliação do desempenho da locomoção para hemiparéticos

Abstract

The ABILOCO is a performance-based measure for individuals with stroke, which explores a representative repertoire of locomotion activities. The ABILOCO was developed in English and to be applied within clinical and research contexts in Brazil, its cultural adaptation is required. The process of cross-cultural adaptation should follow standardized procedures, to ensure that the adapted version reaches the semantic, idiomatic, cultural, and conceptual equivalence. Thus, the aims of this study were to translate into the Portuguese-Brazil language the English version of the ABILOCO and to adapt it to the Brazilian culture, as well as to assess the measurement properties of the adapted version with sub-acute and chronic stroke subjects. The cross-cultural adaptation of the ABILOCO followed standardized procedures. The adapted version (ABILOCO-Brazil) was administred to 136 stroke subjects for the assessment of its measurement properties, using Rash analysis. The ABILOCO divided the sample into two levels of locomotion ability and the items into about seven levels of difficulty, leading to person and item reliability índices of 0.65 and 0.95, respectively and internal consistency of 0.76. The mean measure of the participants was 2.32 logits, whereas the mean values for the individuals were Infit:[MnSq=1,0;t=0]; Outfit:[MnSq=0,94;t=0,2] and for the items were Infit:[MnSq=0,97;t= -0,1]; Outfit:[MnSq=0,96;t=0,3]. The principal component analysis of the residuals showed that the first dimension explained 45% of the variance in locomotion ability, however, the eigenvalue was 1.92, demonstrating the unidimensionality of the ABILOCO. The item-person map showed a large ceiling effect, since 21 subjects (15.4%) scored all the items as possible. The differential item functioning analysis revealed that although there were found diferences in the item calibrations across the countires, they did not impact the estimates of locomotion ability. Therefore, the ABILOCO-Brasil demonstrated satisfactory measurement properties to be used within both clinical and research contexts in Brazil and cross-cultural validity for use in international/multicentric studies. However, its ceiling effect was large, suggesting that the ABILOCO may not be appropriate to assess individuals with high levels of locomotion ability. It is also suggested that the ABILOCO-Brasil be applied along with other standardized measures, in order to obtain a more comprehensive assessment of the ambulation ability of stroke subjects.