02894nas a2200349   4500008004100000245008300041210006900124260000800193300001100201490000700212520176600219653003001985653002802015653001502043653001002058653000902068653002202077653001102099653001902110653001102129653000902140653001602149653006202165653006102227653003302288653003602321653003102357653002602388100001402414700001602428856010002444       2002                        eng d00aDevelopment of an index of physical functional health status in rehabilitation0 aDevelopment of an index of physical functional health status in   cMay  a655-650 v833 aOBJECTIVE: To describe (1) the development of an index of physical functional health status (FHS) and (2) its hierarchical structure, unidimensionality, reproducibility of item calibrations, and practical application. DESIGN: Rasch analysis of existing data sets. SETTING: A total of 715 acute, orthopedic outpatient centers and 62 long-term care facilities in 41 states participating with Focus On Therapeutic Outcomes, Inc. PATIENTS: A convenience sample of 92,343 patients (40% male; mean age +/- standard deviation [SD], 48+/-17y; range, 14-99y) seeking rehabilitation between 1993 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients completed self-report health status surveys at admission and discharge. The Medical Outcomes Study 36-Item Short-Form Health Survey's physical functioning scale (PF-10) is the foundation of the physical FHS. The Oswestry Low Back Pain Disability Questionnaire, Neck Disability Index, Lysholm Knee Questionnaire, items pertinent to patients with upper-extremity impairments, and items pertinent to patients with more involved neuromusculoskeletal impairments were cocalibrated into the PF-10. RESULTS: The final FHS item bank contained 36 items (patient separation, 2.3; root mean square measurement error, 5.9; mean square +/- SD infit, 0.9+/-0.5; outfit, 0.9+/-0.9). Analyses supported empirical item hierarchy, unidimensionality, reproducibility of item calibrations, and content and construct validity of the FHS-36. CONCLUSIONS: Results support the reliability and validity of FHS-36 measures in the present sample. Analyses show the potential for a dynamic, computer-controlled, adaptive survey for FHS assessment applicable for group analysis and clinical decision making for individual patients.10a*Health Status Indicators10a*Rehabilitation Centers10aAdolescent10aAdult10aAged10aAged, 80 and over10aFemale10aHealth Surveys10aHumans10aMale10aMiddle Aged10aMusculoskeletal Diseases/*physiopathology/*rehabilitation10aNervous System Diseases/*physiopathology/*rehabilitation10aPhysical Fitness/*physiology10aRecovery of Function/physiology10aReproducibility of Results10aRetrospective Studies1 aHart, D L1 aWright, B D  uhttp://www.iacat.org/content/development-index-physical-functional-health-status-rehabilitation