ABSTRACT
BACKGROUND: Reintegration to Normal Living Index (RNLI) is a generic 11-item questionnaire-based instrument that measures the degree to which individuals achieve reintegration to normal social activities. OBJECTIVES: This systematic review aimed to provide an overview of the use of this questionnaire in rehabilitation (objective 1) and to analyze its psychometric properties (objective 2). METHODS: We searched the literature in 4 electronic databases (MEDLINE via PubMed, Embase, CINAHL and Web of Science) for articles published in English or French between 1988 and 2017. Studies that used RNLI or investigated at least one of its psychometric properties were included and analyzed according to the PRISMA statement. Data extraction and critical methodological appraisal of the articles were independently performed by 2 authors. RESULTS: A total of 117 studies met the inclusion criteria for objective 1. Half of these studies were conducted in North America (50.4%), mainly with stroke patients. The RNLI was used according to 7 different response formats. The 0-10 visual analog scale and 3-point Likert scale were the most commonly used response formats. For objective 2, 10 studies had evaluated the psychometric properties of the RNLI. Their results suggested good test-retest reliability (intraclass coefficient: 0.83-0.87); good internal consistency (Cronbach α: 0.73-0.97); poor to good construct validity, with Pearson's or Spearman's correlation coefficients between the RNLI and scores for many other well-known questionnaires ranging from 0.25 to 0.77. Other types of psychometric properties (e.g., responsiveness) were poorly investigated. CONCLUSION: Despite the increasing use of RNLI in clinical studies, some aspects of its psychometric properties are still poorly evaluated. In addition to the validity and reliability shown in different studies, further studies are needed to investigate other measurement properties such as responsiveness.
