Discriminant Validity of the Electronic Activity Card Sort (ACS3) Among Adults With Traumatic Brain Injury and Multiple Sclerosis.

Abstract

Importance: The Electronic Activity Card Sort (ACS3) is an online adaptation of the in-person Activity Card Sort (ACS). It is important to validate the ACS3 within clinical populations.

Objective: To assess the discriminant validity of the ACS3 between persons with multiple sclerosis (MS) and those with traumatic brain injury (TBI).

Design: Cross-sectional.

Setting: Telehealth.

Participants: Community-dwelling adults with either MS (n = 11) or TBI (n = 11).

Outcomes and measures: The ACS3 was administered via virtual interview. Analyses (t tests) were conducted to compare persons with TBI and those with MS on the ACS3 and compare the preinjury or preillness and current activity scores for each group. Correlations between demographic characteristics and ACS3 scores were computed, using Pearson correlations for continuous variables and Spearman correlations for categorical data.

Results: All participants (n = 22) demonstrated significant reductions from before to after injury/illness for each domain and total ACS3 scores. Furthermore, the MS group retained fewer activities than the TBI group in the ACS3 total score.

Conclusions and relevance: The results provide preliminary evidence for the discriminant validity of the ACS3's capacity to distinguish between adults with MS and those with TBI. The ACS3 may be a clinically useful tool for evaluating life participation in persons with chronic neurological conditions. Plain-Language Summary: Involvement in life situations, or participation, is an essential outcome in rehabilitation, and is associated with higher quality of life, decreased depression, and better overall well-being. Changes in health can reduce participation in meaningful life activities, which can negatively affect independence and life satisfaction. Meaningful patient engagement emphasizes and supports patient participation as an essential outcome in rehabilitation that includes occupational therapy. The Electronic Activity Card Sort (ACS3) is an online adaptation of the in-person Activity Card Sort (ACS). The ACS3 is a virtual option for measuring participation in adults with chronic neurological conditions. This study explored using ACS3 to identify changes in participation levels between adults with multiple sclerosis (MS) and those with traumatic brain injury (TBI). The study factored in both current and previous participation levels. Using ACS3, occupational therapists were able to differentiate participation patterns among those with MS and those with TBI. In a clinical setting, ACS3 can be used to guide personalized rehabilitation strategies for two distinct neurological conditions, thereby improving patient outcomes.