Reproducibility, Construct Validity, and Responsiveness of the Tetraplegia Upper Limb Activities Questionnaire, TUAQ. Part 2

Abstract

Objective: To test reliability, construct validity and responsiveness of the Tetraplegia Upper Limb Activities Questionnaire (TUAQ), a patient-reported outcome measure that assesses perceived performance and satisfaction with 10 standardized activities.

Design: Outcome measure psychometric evaluation.

Setting: Spinal cord injury units in 2 countries.

Participants: Reproducibility: 47 individuals with tetraplegia. Construct validity and responsiveness: 33 individuals with tetraplegia undergoing surgery to restore hand function (N=80).

Interventions: Reproducibility: The TUAQ was completed on 2 occasions, 2 weeks apart. Construct validity and responsiveness: Participants completed the TUAQ prior to surgery and 3-12 months after hand reconstruction surgery. Internal consistency was examined using Cronbach α. Two agreement parameters were examined: the SEM and minimal detectable change with 90% confidence interval (MDC₉₀). Construct validity was evaluated using Pearson product moment correlation against a priori hypotheses. Responsiveness was assessed using paired t tests and effect size.

Results: Test-retest reliability and internal consistency was high (intraclass correlation coefficient of 0.89 for performance scale and 0.88 for satisfaction, Cronbach α of 0.92 and 0.90, respectively). For agreement the SEM scores were 4.7 and 3.5, with MDC₉₀ of 10.9 and 8.2, respectively. Responsiveness and construct validity showed sound results with no ceiling or floor effects and with large effect size (>1.05).

Conclusions: The TUAQ demonstrates good psychometric properties for reliability and agreement for persons with tetraplegia and responsiveness and construct validity for surgical reconstruction of hand function for persons with tetraplegia. The TUAQ appears appropriate to be used as a patient-reported outcome measure for clinical and research purposes in this population.

Keywords: Patient reported outcome measures; Psychometrics; Quadriplegia; Rehabilitation; Upper extremity.