Development of a disease-specific health-related quality of life questionnaire for patients with post-stroke spasticity

OBJECTIVE: This study was designed to develop a disease-specific health-related quality of life (HR-QOL) measure for patients with post-stroke spasticity. METHODS: Based on responses from 20 patients with post-stroke spasticity and an extensive literature search, items potentially used to measure these patients' recovery status were identified and the Apoplexy Spastic-Paralysis Questionnaire (ASPQ) was formed. A sample of 106 patients was then tested twice using the ASPQ, the Self-rating Depression Scale (SDS) and the Stroke-specific Quality of Life (SS-QOL). Clinicians also examined all the patients using the Ashworth Scale (AS). Internal reliability was assessed using Cronbach's coefficient a, while construct validity was determined using principal component analysis (PCA). Empirical validity was evaluated between patients with depression and those without depression by single factor analysis. Sensitivity was examined by calculating the Spearman correlation coefficient between the changes in scores of the ASPQ, the AS and the SS-QOL. RESULTS: The ASPQ had adequate internal consistency reliability (alpha=0.874) and sensitivity, with significant correlations between the changes in scores of the AS, the SS-QOL and the ASPQ, with three domains. In a construct validity test, six factors were extracted; the overall variance explained by all factors was 72.6%. For empirical validity, mean values of 19 items and 3 domains were all higher in the depressive patients than in the non-depressive patients. CONCLUSION: The ASPQ is a reliable and valid self-rating scale for measuring the HR-QOL in patients with post-stroke spasticity. (C) 2012 JTCM. All rights reserved.