Impact of Participation and Autonomy Questionnaire

Combined 5 diagnostic groups (neuromuscular disease, stroke, SCI, rheumatoid arthritis, fibromyalgia):

(Cardol et al, 2001, n = 126; 21 SCI, mean age 46.1(13.5), 1-27 years post injury)

*Adequate to Excellent K value for problem experience scores: 0.59-0.87.

Multiple Diagnoses:

(Sibley et al, 2005; n = 213; multiple sclerosis, spinal cord injury, rheumatoid arthritis and general practice; median age = 54) 

• Item to total subscale correlations
• Indoor autonomy Item-total subscale correlations range: 0.73-0.89
• Family role Item-total subscale correlations range: 0.73-0.84 (except item 4a item-total subscale correlation = 0.34)
• Outdoor autonomy Item-total subscale correlations range: 0.69-0.83
• Social life and relationships Item-total subscale correlations range: 0.52-0.76
• Work and education Item-total subscale correlations range: 0.52-0.77
• Test retest for all items: Weighted Kappa statistic were greater than 0.6 (range: 0.64-0.92)
• Excellent Test-Retest Reliability at the Subscale level
  • Indoor autonomy: 0.95
  • Family role: 0.97
  • Outdoor autonomy: 0.97
  • Social life and relationships: 0.94
  • Work and education: 0.91

Consecutive outpatients with a variety of diagnosis:

(Cardol, et al, 1999, n = 100; 3 SCI, mean age = 47.9(14.6))

Neuromuscular disease, stroke, spinal cord injury (SCI), rheumatoid arthritis, or fibromyalgia:

(Cardol et al, 2001; n = 126; Response rates of the various diagnostic groups differed: 86% response for neuromuscular disease, 47% for SCI, 45% for stroke, 42% for rheumatoid arthritis, and 37% for fibromyalgia. Mean age of the study population= 52.6(13.4) years; 78 of the respondents were women. Median duration of disease ranged between 2 and 12 years.) 

• Excellent internal consistency (Cronbach’s Alpha):
  • 0.91 (autonomy indoors)
  • 0.90 (family role)
  • 0.81 (autonomy outdoors)
  • 0.86 (social relations)
  • 0.91 (work and educational opportunities)

Multiple Diagnoses:

(Sibley et al, 2006; n = 213; multiple sclerosis, spinal cord injury, rheumatoid arthritis and general practice; median age = 54) 

• Excellent Internal Consistency (Cronbach’s Alpha):
  • Indoor autonomy: 0.94
  • Family role: 0.90
  • Outdoor autonomy: 0.91
  • Social life and relationships: 0.86
  • Work and education: 0.90

Combined 5 diagnostic groups (neuromuscular disease, stroke, SCI, rheumatoid arthritis, fibromyalgia): 

Convergent Validity

(Cardol et al, 2001)

• Poor correlation between the IPA domain of autonomy outdoors and the Sickness Impact Profile's physical dimension (r = 0.29)
• Adequate correlation between the IPA domains of autonomy indoors, autonomy outdoors, and family role and the SF-36's physical domains (r = -0.43, -0.51, 0.49, respectively)
• Adequate correlation between the IPA and the London Handicap Scale domains of mobility, physical independence, occupation, and integration (r = -0.42 to -0.57)

Discriminant Validity

(Cardol et al, 2001)

• Poor correlation between the IPA Scale domains and the London Handicap Scale domains (r = -0.29 to 0.01)
• Poor correlation between IPA domain of social relationships and the SF-36 physical domain (r = -0.36)
• Poor correlation between IPA domain of social relationships and the SIP physical domain (r = -0.16)

Multiple Diagnoses:

(Sibley et al, 2006; n = 213; multiple sclerosis, spinal cord injury, rheumatoid arthritis and general practice; median age = 54) 

Construct Validity

• Normal Fit Index = 0.98, Comparative Fit Index = 0.99 indicating a good fit to the model
• Convergent and discriminant validity were confirmed by the predicted associations, or lack thereof, with the exception of a poor association between the ‘social life/relationships’ IPA subscale and Functional Limitations Profile-Emotion

Consecutive outpatients with a variety of diagnoses:

(Cardol, et al, 1999, n = 100; 3 SCI, mean age 47.9(14.6))

• The IPA is based on the participation definition contained in the ICIDH-2, clinical experience of the multi-disciplinary research group, and a small qualitative study with rehabilitation patients.
• Established based on input from a multidisciplinary clinical research group, external experts, and a qualitative study with rehabilitation patients

Consecutive individuals referred for OP rehabilitation of various diagnoses:

(Cardol et al, 2002, n = 17)

Traumatic or non-traumatic SCI; spinal column fracture without neurological involvement; spinal degenerative disease:

(Noonan et al, 2010, n = 545; 79 SCI)

Traumatic or non-traumatic SCI; spinal column fracture without neurological involvement; spinal degenerative disease:

(Noonan et al, 2010)

*Due to high ceiling effects of IPA, study reports it is impossible to detect improvements beyond measurement error for majority of domains. MDC are based on one individual level changes.
 

Traumatic or non-traumatic SCI; spinal column fracture without neuro involvement; spinal degenerative disease:

(Noonan et al, 2010, n = 139)

Traumatic or non-traumatic SCI; spinal column fracture without neuro involvement; spinal degenerative disease:

(Noonan et al, 2010, n = 545, 79 SCI)

SCI:

(Lund et al, 2007, n = 161, mean age 52(18.2), Swedish rehab unit)

• Adequate Ceiling/Floor Effect: Rasch analysis showed that 20% of people were either above or below the range of item calibration values - indication of floor and ceiling effects

Traumatic or non-traumatic SCI; spinal column fracture without neuro involvement; spinal degenerative disease:

(Noonan et al, 2010)

Parkinson's Disease:

(Franchignoni at al, 2007; n = 100 patients with Parkinson's Disease, 41 male, 59 female; mean age = 72(7) years; HY 2.5(1.5-4))

• SEM = 0.53

Parkinson's Disease:

(Franchignoni at al, 2007)

• Excellent correlation between IPA-I and PDQ-39 (r = 0.72)
• Excellent correlation between IPA-II and PDQ-39 (r = 0.74)
• Poor correlation between IPA-I and UPDRS-ME (r = 0.26)
• Poor correlation between IPA-I and UPDRS-ADL (r = 0.37)
• Poor correlation between IPA-II and HY (r = 0.21)
• Poor correlation between IPA-II and UPDRS-ADL (r = -0.26)