%0 Journal Article %J Archives of Physical Medicine and Rehabilitation %D 2002 %T Development of an index of physical functional health status in rehabilitation %A Hart, D. L. %A Wright, B. D. %K *Health Status Indicators %K *Rehabilitation Centers %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Female %K Health Surveys %K Humans %K Male %K Middle Aged %K Musculoskeletal Diseases/*physiopathology/*rehabilitation %K Nervous System Diseases/*physiopathology/*rehabilitation %K Physical Fitness/*physiology %K Recovery of Function/physiology %K Reproducibility of Results %K Retrospective Studies %X OBJECTIVE: 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. %B Archives of Physical Medicine and Rehabilitation %V 83 %P 655-65 %8 May %G eng %M 11994805