***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVES To apply Rasch analysis to evaluate the psychometric properties of the composite score of the 3 upper limb subscales of the Motor Assessment Scale ( UL-MAS ) when administered in the acute/subacute phase post-stroke . DESIGN Prospect i ve data collection of UL-MAS scores . PARTICIPANTS Eighty Eighty individuals a mean of 64.8 days ( st and ard deviation 53.3 ; range 4 - 193 days ) following the onset of unilateral stroke . METHODS All UL-MAS test items were administered in 30 participants assessed longitudinally over 3 occasions , and in 50 participants assessed on a single occasion . These 140 observations were pooled to be evaluated using Rasch analysis . RESULTS With the elimination of the wrist radial deviation test item , the UL-MAS demonstrated uni-dimensionality with no significant test item response bias . The test item difficulty hierarchy was vali date d in the Upper Arm and H and Movements subscales , but not in the Advanced H and Activities subscale . The acceptable floor ( 14 % ) and ceiling ( 9 % ) effects and the high Person Separation Reliability Index ( 0.96 ) indicated that the scale was appropriately targeted to discriminate statistically between groups of acute/subacute stroke participants with differing upper limb motor recovery . CONCLUSION The findings support the psychometric properties of the composite UL-MAS score in this clinical population St and ardized assessment s are critical for advancing clinical rehabilitation , yet assessment scores often provide little information for rehabilitation treatment planning . A keyform recovery map is an innovative way for a therapist to record patient responses to st and ardized assessment items . The form enables a therapist to view the specific items that a patient can or can not perform . This information can assist a therapist in tailoring treatments to a patient 's individual ability level . We demonstrate how a keyform recovery map can be used to inform clinical treatment planning for individuals with stroke-related upper-limb motor impairment . A keyform map of poststroke upper-limb recovery defined by items of the Fugl-Meyer Assessment -Upper Extremity ( FMA-UE ) was generated by a previously published Rasch analysis . Three individuals with stroke enrolled in a separate research study were r and omly selected from each of the three impairment strata of the FMA-UE . Their performance on each item was displayed on the FMA-UE keyform . The forms directly connected qualitative descriptions of patients ' motor ability to assessment measures , thereby suggesting appropriate shorter and longer term rehabilitation goals . This study demonstrates how measurement theory can be used to translate a st and ardized assessment into a useful , evidence -based tool for making clinical practice decisions BACKGROUND AND PURPOSE To improve the accuracy of early postonset prediction of motor recovery in the flaccid hemiplegic arm , the effects of change in motor function over time on the accuracy of prediction were evaluated , and a prediction model for the probability of regaining dexterity at 6 months was developed . METHODS In 102 stroke patients , dexterity and paresis were measured with the  Action Research Arm Test , Motricity Index , and Fugl-Meyer motor evaluation .  For model development , 23 c and i date determinants were selected . Logistic regression analysis was used for prognostic factors and model development . RESULTS At 6 months , some dexterity in the paretic arm was found in 38 % , and complete functional recovery was seen in 11.6 % of the patients . Total anterior circulation infa rcts , right hemisphere strokes , homonymous hemianopia , visual gaze deficit , visual inattention , and paresis were statistically significant related to a poor arm function . Motricity Index leg scores of at least 25 points in the first week and Fugl-Meyer arm scores of 11 points in the second week increasing to 19 points in the fourth week raised the probability of developing some dexterity ( Action Research Arm Test > or=10 points ) from 74 % ( positive predictive value [ PPV ] , 0.74 ; 95 % confidence interval [ CI ] , 0.63 to 0.86 ) to 94 % ( PPV , 0.83 ; 95 % CI , 0.76 to 0.91 ) at 6 months . No change in probabilities of prediction dexterity was found after 4 weeks . CONCLUSIONS Based on the Fugl-Meyer scores of the flaccid arm , optimal prediction of arm function outcome at 6 months can be made within 4 weeks after onset . Lack of voluntary motor control of the leg in the first week with no emergence of arm synergies at 4 weeks is associated with poor outcome at 6 months Our objective was to verify and exp and previous evidence of psychometric inadequacies in the ALSFRS-R , in a different sample of subjects suffering from ALS . Since 2009 , a prospect i ve registry records all incident cases of ALS in Emilia Romagna Region , Italy ( 4.4 million inhabitants ) referred to its 17 neurological departments . For each patient , demographic and clinical information is collected by the physician in charge , including compilation of the ALSFRS-R at each clinical follow-up . Results showed that a confirmatory factor analysis on the three-factor model previously found ( bulbar , motor , respiratory function ) showed a good fit . Rasch analysis on the whole scale showed the need to collapse some rating categories , confirmed the multidimensionality of the ALSFRS-R , and demonstrated the presence of differential item functioning between patients with spinal versus bulbar onset . Moreover , some items included in the three ALSFRS-R subscales showed a problematic fit to the respective construct they were intended to measure . In conclusion , the interpretation of a total raw score of ALSFRS-R is hampered by ambiguities due to the different metric properties of the three domains the scale aggregates , and their content and structure . This study confirms that a refinement of ALSFRS-R is warranted , pointing to the need to revise its whole structure , and providing detailed guidelines for its revision Background The construct validity and reliability of the short form of the Wolf Motor Function Test ( S-WMFT ) in people with subacute stroke and chronic stroke  ( S-WMFT subacute stroke and chronic stroke versions ) have not been investigated . Objective The purpose of this study was to investigate the dimensionality , item difficulty hierarchy , differential item functioning ( DIF ) , and reliability of the S-WMFT subacute stroke and chronic stroke versions in people with mild to moderate upper-extremity ( UE ) dysfunction . Design This was a secondary study in which data collected from r and omized controlled trials were used . Methods Data were collected at baseline from 97 people with chronic stroke ( > 12 months after stroke ) and 75 people with subacute stroke ( 3–9 months after stroke ) at 3 medical centers in Taiwan .  Test structure , hierarchical properties , DIF , and reliability were assessed with Rasch analysis . Results The test structure for both versions was unidimensional . No DIF relevant to sex , age , or stroke location ( hemispheric laterality ) was detected . The tasks of moving a h and to a box and moving a h and to a table in the S-WMFT for subacute stroke showed a significantly high correlation . The reliability coefficients for both versions were approximately .90 . Limitations The findings were limited to people with stroke and mild to moderate impairment of UE function . Conclusions The S-WMFT subacute stroke and chronic stroke versions are useful tools for assessing UE function in different subgroups of people with stroke and show evidence of construct validity and reliability . A high correlation between the tasks of moving a h and to a box and moving a h and to a table in the S-WMFT for subacute stroke suggests that the removal of 1 of these 2 items is warranted OBJECTIVE To investigate the dimensionality and construct validity of the Fugl-Meyer Assessment of the upper extremity by using Rasch analysis . DESIGN Secondary analysis of pooled data from 2 existing data sets : a r and omized therapeutic exercise clinical trial and a cohort longitudinal study of stroke recovery . SETTING University research center . PARTICIPANTS A total of 512 subjects , ages 69.8+/-11.1 years , who were 0 to 145 days poststroke . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Dimensionality was examined with principal components analysis and Rasch item-fit statistics . The Rasch-derived item hierarchy was examined for consistency with the expected course of poststroke upper-extremity recovery suggested by the reflex-hierarchical conceptual model underlying the assessment . RESULTS Factor loadings and item infit statistics suggested that the 3 reflex items were empirically disconnected from other assessment items . The reflex items were removed . The modified 30-item assessment showed a unidimensional structure . The Rasch-item-difficulty order was not consistent with the expected item order . CONCLUSIONS The items testing resting-state reflexes may threaten the assessment 's dimensionality . With reflex items removed , the assessment is a unidimensional measure of volitional movement . The Rasch-generated item-difficulty order challenges the hierarchical structure implied by the instrument 's underlying conceptual framework 
    Output:
    
The review ed psychometric properties of UE outcome measures are useful for clinicians in deciding which measures to use to assess patients ’ UE impairments