Development of a Self-Report Physical Function Instrument for Disability Assessment: Item Pool Construction and Factor Analysis

Arch Phys Med Rehabil, 2013 · DOI: 10.1016/j.apmr.2013.03.011 · Published: September 1, 2013

Participation Disability Research Methodology & Design

Simple Explanation

This study aimed to create a comprehensive set of questions to assess physical functioning relevant to work, for use in Social Security Administration (SSA) disability programs. The researchers reviewed existing literature, gathered expert opinions, conducted interviews, and performed statistical analyses to refine the question set. The result was a set of questions that can be used to reliably assess a claimant's physical abilities in four key areas: body position, mobility, upper body function, and fine motor skills.

Study Duration

Not specified

Participants

1,017 SSA claimants, and a normative sample of 999 adults

Evidence Level

Not specified

Key Findings

1
The final item pool consisted of 139 items representing various physical activities.
2
Factor analysis revealed a 4-factor solution: Changing and Maintaining Body Position, Whole Body Mobility, Upper Body Function, and Upper Extremity Fine Motor.
3
Confirmatory factor analyses demonstrated very good fit for the 4-factor models in both claimant and normative samples.

Research Summary

The study developed a comprehensive item pool for assessing physical function within SSA disability programs, using literature review, expert input, and stakeholder interviews. Factor analysis identified a 4-factor structure representing key aspects of physical functioning relevant to work: Changing and Maintaining Body Position, Whole Body Mobility, Upper Body Function, and Upper Extremity Fine Motor. The resulting SSA-PF instrument offers promise for providing reliable information about claimant physical functioning relevant to work disability determinations.

Practical Implications

Enhanced Disability Assessment

The SSA-PF instrument can improve the efficiency and accuracy of disability determinations by providing a standardized measure of physical functioning.

Improved Claimant Profiling

The 4-factor structure allows for a detailed profile of a claimant's functional abilities across different domains, aiding in targeted interventions and support.

Informed CAT Development

The item pool and factor structure provide a foundation for developing a computer-adaptive testing (CAT) system to further enhance the efficiency and precision of disability assessments.

Study Limitations

1
The results of the replication unidimensional CFA’s (Table 3) were mixed regarding fit, with relatively high RMSEAs and chi-square/df values.
2
Our CFA revealed items that demonstrated local dependence.
3
Additional research is needed to assess the measurement properties of the instrument as developed.

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