Phd in CLINICAL EXPERIMENTAL NEUROSCIENCE AND PSYCHIATRY

Thesis title: Cross-Cultural Adaptation and Psychometric Evaluation of Tools for Language, Voice and Swallowing Disorders

ABSTRACT Neurological and musculoskeletal disorders often lead to persistent impairments affecting a person’s ability to function in daily life. Accurate and reliable outcome measures are essential to assess the impact of these impairments, monitor change, and guide rehabilitation strategies. This PhD thesis aimed to advance the development, validation, and clinical applicability of outcome measures for individuals with neurological and musculoskeletal conditions, with particular attention to communication, swallowing, and cervical function. The research was grounded in the International Classification of Functioning, Disability and Health (ICF) and informed by COSMIN guidelines for evaluating measurement properties. The first study validated the Italian version of the Mann Assessment of Swallowing Ability (MASA-IT) in individuals with Parkinson’s disease, confirming its strong psychometric properties for clinical use. The second study involved the cross- cultural adaptation of the Vocal Fatigue Index (VFI-I), a self-report tool for assessing voice-related fatigue. Results confirmed a stable factor structure and good construct validity. The third study was a systematic review of aphasia assessments, highlighting a paucity of tools with adequate psychometric validation and offering guidance for clinicians and researchers on their strengths and limitations. The fourth study focused on the Italian validation of the Munich Dysphagia Test (MDT- IT), a widely used tool for assessing neck-related disability. The study confirmed its unidimensionality, reliability, and responsiveness, reinforcing its clinical relevance in both musculoskeletal and neurological settings. Together, these studies support the use of robust, standardized, and culturally adapted outcome measures in rehabilitation, enhancing person- centered care and interdisciplinary communication. They also highlight the importance of methodological rigor in developing and validating tools that accurately capture function, participation, and quality of life in diverse populations.