# Praxis function in the ADL Observation Scale: Spanish cross-cultural adaptation and psychometric properties

## TL;DR

This paper adapts and validates a scale to assess praxis function in stroke patients in Spanish, showing it is reliable and accurate.

## Contribution

The study provides a cross-culturally adapted and psychometrically validated Spanish version of the ADL Observation Scale for stroke patients.

## Key findings

- The Spanish version of the ADL Observation Scale has a four-factor structure with good fit indices.
- The scale demonstrated high internal consistency and strong diagnostic accuracy for praxis deficits.
- Cut-off points were established for each factor to classify patients effectively.

## Abstract

To cross-cultural adapt the ADL Observation Scale and evaluate its psychometric properties in a sample of Spanish-speaking patients with stroke.

A validation study that included cross-cultural adaptation, structural validity assessment, reliability, and diagnostic accuracy analysis. The study followed COSMIN and STARD criteria. Translation and cross-cultural adaptation of the ADL Observation Scale followed a backward translation process. Structural validity was assessed with confirmatory factor analysis, and internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega coefficient. Cut-off points were estimated using ROC analysis, and diagnostic accuracy was evaluated using sensitivity, specificity, and positive and negative predictive values. Internal consistency, cut-off points, and diagnostic accuracy were calculated for two different age groups (≥65 years; > 65 years).

The Spanish version of the ADL Observation Scale was obtained after cross-cultural adaptation. The psychometric properties were tested in a sample of 180 patients with stroke. Structural validity showed a four-factor structure of the scale (RMSEA = 0.078; CFI = 0.952; TLI = 0.934). Internal consistency for each factor indicated Omega values between 0.641, 95% CI [0.495, 0.753], and 0.915, 95% CI [0.882, 0.936]. Cut-off points, also calculated for each factor, ranged from ≥1 to ≥4 points. Sensitivity, specificity, and positive and negative predictive values showed high values, indicating the scale’s discriminatory capacity for correctly classifying patients with praxis deficits.

The ADL Observation Scale has a four-factor structure, and it is a reliable instrument for evaluating the levels of praxis function in daily living among Spanish-speaking patients with stroke. The scale also has adequate diagnostic accuracy in detecting patients with praxis deficits.