Transforming a Traumatic Brain Injury Measure of Participation into a Psychometrically Sound Spinal Cord Injury Participation Measure

Abstract Objective To evaluate the use of Participation Assessed with Recombined Tools – Objective (PART-O) in spinal cord injury (SCI) and compare it with the Craig Handicap Assessment and Reporting Technique – Short Form (CHART-SF). Design Follow-up survey of inception cohort. Setting Community. Participants Individuals with SCI, rehabilitated at 2 large SCI Model Systems and enrolled in the SCI Model Systems National Database, who were due for routine follow-up (N = 468, median age at injury of 29, and median time post injury of 5 years). Interventions Not applicable Main Outcome Measures: PART-O and CHART-SF. Results Use of Rasch analysis identified an SCI-specific scoring of PART-O that demonstrated unidimensionality (first contrast eigenvalue of 1.76) with no misfitting items or disordered steps in any response categories. Person separation and reliability were 2.00 and .80 respectively. Unlike CHART-SF, PART-O had a relatively normal distribution with no floor or ceiling effects. Test-retest reliability PART-O administered 2-4 weeks apart was .97, with a reliable change index of 3.1 points on a 100 point scale. PART-O correlated .79 with the sum of 3 CHART-SF domains with similar content. The PART-O scoring was initially validated on a second dataset. Conclusions PART-O can be used successfully to measure participation in a population of people with SCI. A new method of scoring PART-O in SCI provides an initially validated, univariate interval measure of participation with good psychometric properties that has advantages over the CHART-SF legacy measure of participation.