Abstract
Abstract: :
Purpose: To evaluate the Functional Assessment of Self-reliance on Tasks (FAST), a clinical performance measure designed to assess functional ability in low vision and blind rehabilitation training programs. Methods: A sample of 500 legally blind veterans (mean age=73) enrolled at the South Western Blind Rehabilitation Center were assessed by trained clinicians using the 11-item FAST. Patients are rated on a 10-point scale based on how they perform on ADL and IADL tasks at admission and discharge. Results: Rasch analysis was used to estimate the functional ability required by each item for a particular response (item measures) and to estimate the functional ability of each patient (person measures). The validity of the model was evaluated by examining the distributions of residuals for item and person measures. We observed that person measures remain unchanged from admission to discharge while item measures shifted in their level of difficulty, becoming much easier at discharge. The item ordering showed good separation and high reliability (S=10.35, R=0.99). In addition, raters endorsed all intervals of the 10-point scale for each of the items. Conclusion: The results indicate that the FAST effectively measures changes in levels of functional ability in blind rehabilitation patients. The FAST is a good compromise between an in-depth assessment, requiring extensive time on the part of staff, and a global screening measure. As a result, the FAST is able to provide clinically relevant information that assists clinicians in identifying necessary training activities, facilitating client placement, and determining appropriate lengths of treatments. Finally, the FAST is able to capture training effects, something previously unseen in blind rehabilitation.
Keywords: 459 low vision • 350 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology • 359 clinical research methodology