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Functional and Social Limitations After Facial Palsy: Expanded and Independent Validation of the Italian Version of the Facial Disability Index

Chiara Pavese, Miriam Cecini, Nora Camerino, Annalisa De Silvestri, Carmine Tinelli, Maurizio Bejor, Elena Dalla Toffola
DOI: 10.2522/ptj.20130254 Published 1 September 2014
Chiara Pavese
C. Pavese, MD, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy.
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Miriam Cecini
M. Cecini, MD, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia.
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Nora Camerino
N. Camerino, MD, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia.
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Annalisa De Silvestri
A. De Silvestri, MSc, Biometric Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
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Carmine Tinelli
C. Tinelli, MD, Biometric Unit, Fondazione IRCCS Policlinico San Matteo.
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Maurizio Bejor
M. Bejor, MD, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, and Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
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Elena Dalla Toffola
E. Dalla Toffola, MD, Department of Clinical, Surgical, Diagnostic and Pediatric Sciences, University of Pavia, and Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Mailing address: Rehabilitation Unit, Fondazione IRCCS Policlinico San Matteo, Viale Golgi 19, 27100 Pavia, Italy.
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Abstract

Background The Facial Disability Index (FDI) is widely used for self-assessment of functional impairment and quality of life in patients with facial palsy.

Objective The study aim was to complete the validation of the FDI by generating an Italian version (IT-FDI) and evaluating its clinimetric properties.

Design This was a longitudinal, observational measurement study.

Methods The questionnaire was translated, cross-culturally adapted, and administered to 100 consecutive participants (outpatients) with facial palsy. The clinical severity of facial palsy, impairments in physical and social function, and quality of life were evaluated with the Sunnybrook Facial Grading System, IT-FDI, and 12-Item Short-Form Health Survey.

Results The IT-FDI showed excellent test-retest reliability for every item and for total scores (intraclass correlation coefficients of .93 and .84 for physical function subscale and social/well-being function subscale, respectively). The IT-FDI confirmed the high internal consistency of the original version, with theta coefficients of .82 for the physical function subscale and .78 for the social/well-being function subscale. The physical function subscale correlated with the Sunnybrook Facial Grading System composite score (r=.44), and the social/well-being function subscale correlated with the 12-Item Short-Form Health Survey mental component (r=.55). The IT-FDI confirmed the good responsiveness of the original version, as expressed by effect size, standardized response mean, and responsiveness ratio of, respectively, 1, 1.03, and 1.21 for the physical function subscale and 0.75, 0.83, and 1.15 for the social/well-being function subscale.

Limitations Responsiveness was evaluated with a limited number of participants.

Conclusions The results demonstrated the test-retest reliability for all items of the FDI and confirmed its internal consistency, construct validity, and responsiveness with an independent and larger clinical subset. This study completes the validation of the FDI and provides the first validated questionnaire in Italian for assessment of disability and quality of life specifically in patients with facial palsy.

Footnotes

  • Dr Pavese, Dr Tinelli, and Professor Dalla Toffola provided concept/idea/research design. Dr Pavese, Dr Cecini, Dr Camerino, and Professor Dalla Toffola provided data collection. All authors provided data analysis and writing. Dr Pavese and Professor Dalla Toffola provided project management and institutional liaisons. Professor Dalla Toffola provided fund procurement, participants, and facilities/equipment. The authors thank Charlotte Buckmaster for her linguistic expertise.

  • Dr Pavese is partially supported by an Investigator Fellowship from Collegio Ghislieri, Pavia, Italy.

  • Received June 18, 2013.
  • Accepted April 18, 2014.
  • © 2014 American Physical Therapy Association
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Vol 94 Issue 9 Table of Contents
Physical Therapy: 94 (9)

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Functional and Social Limitations After Facial Palsy: Expanded and Independent Validation of the Italian Version of the Facial Disability Index
Chiara Pavese, Miriam Cecini, Nora Camerino, Annalisa De Silvestri, Carmine Tinelli, Maurizio Bejor, Elena Dalla Toffola
Physical Therapy Sep 2014, 94 (9) 1327-1336; DOI: 10.2522/ptj.20130254

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Functional and Social Limitations After Facial Palsy: Expanded and Independent Validation of the Italian Version of the Facial Disability Index
Chiara Pavese, Miriam Cecini, Nora Camerino, Annalisa De Silvestri, Carmine Tinelli, Maurizio Bejor, Elena Dalla Toffola
Physical Therapy Sep 2014, 94 (9) 1327-1336; DOI: 10.2522/ptj.20130254
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