Psychometric testing of the Chinese version of the International Classification of Functioning, Disability, and Health Measure of Participation and Activities Screener in people with stroke

Background: Clinicians need a validated measure to assess the activity and participation of Chinese people with stroke. Objectives: To culturally adapt and psychometrically test the Chinese (Cantonese) version of the International Classification of Functioning, Disability and Health Measure of Participation and Activities (C-IMPACT-S) in community-dwelling people with stroke. Methods: We followed the standard translation procedures to culturally adapt the C-IMPACT-S. Then we administered the C-IMPACT-S to 100 people with stroke and 50 healthy counterparts for psychometric testing, including the ceiling and floor effects, internal consistency, test–retest, measurement error, minimal detectable change, correlations with other outcome measures, known-group validity and optimal cutoff scores. Results: The C-IMPACT-S has no floor effects but ceiling effects in item 5. It has poor to excellent (Cronbach’s α = 0.56–95) internal consistency and fair to excellent (Intraclass correlation coefficients = 0.58–1.00) test-retest reliability. The overall C-IMPACT-S mean score and activity and participation component mean scores had statistically significant no to weak correlations with the Fugl-Meyer Assessment, the Chinese versions of Geriatric Depression Scale, Fatigue Assessment Scale, Lawton Instrumental Activities of Daily Living Scale and Community Integration Measure. The stroke participants had lower C-IMPACT-S scores then their health counterparts. The optimal cutoff scores of the overall C-IMPACT-S and activity and participation domains were 88.02% (sensitivity 72%, specificity 80%), 80.56% (sensitivity 86%, specificity 68%) and 91.67% (sensitivity 68%, specificity 80%), respectively. Conclusions: C-IMPACT-S is a reliable and valid measure for assessing the levels of activity and participation of people with chronic stroke.