Assesses a broad range of activities of daily living in patients recovering from stroke
- The items included move beyond the scope of ADL scales, which tend to focus on issues related to self care and mobility
- Can be separated into 3 factors:
- Domestic chores
- Leisure/work
- Outdoor activities
- Lower Limb Amputation
- Stroke
- Venous Leg Ulcers
- Chronic Low Back Pain
- High Utilizers of Health Care
- Mild Cognitive Impairment
- Traumatic Limb Injury
Stroke:
(Lu et al, 2012; n = 52, mean age = 59.4 (11.6) years, minimum 6 months post stroke, Taiwanese sample, Chronic Stroke)
- SEM = 2.4
(Lin et al, 2012; n = 127, mean age = 55.27 (11.23) years, time post stroke = 16.82 (16.05) months, Taiwanese sample)
- Standard Error of Measurement of individual items:
| Item | Item Difficulty (Standard Error) |
| The domain of domestic chores | |
| Preparing meals | 0.08 |
| Washing dishes | 0.08 |
| Washing clothes | 0.08 |
| Dusting/vacuum cleaning | 0.07 |
| Cleaning (heavy housework) | 0.08 |
| Local shopping | 0.17 |
| The domain of work/leisure | |
| Social activities | 0.07 |
| Walking outside >15 min | 0.08 |
| Hobby/sport | 0.07 |
| Car/bus travel | 0.07 |
| Outings | 0.08 |
| Gardening | 0.09 |
| Household/car maintenance | 0.10 |
| Reading books | 0.08 |
| Employment | 0.23 |
Elderly:
(Imam & Miller, 2012; n = 66, mean age = 79.03 (8.50) years, Chinese/Canadian sample, Elderly)
- MDC value = 8.64
Stroke:
(Lu et al, 2012, Chronic Stroke)
- MDC value = 6.7 (14.9%)
General Population:
(Turnbull et al. 2000, n = 602, aged 16 and older, General Population)
| Age Band (yrs) | n | Median (IQR) (yrs) | Range (yrs) |
| Male | |||
| 16-24 | 24 | 23.5 (17.5 to 30.3) | 10.0 to 37.0 |
| 25-34 | 28 | 28.5 (26.0 to 33.0) | 8.0 to 39.0 |
| 35-44 | 33 | 27.0 (24.0 to 34.0) | 3.0 to 40.0 |
| 45-54 | 34 | 27.0 (23.0 to 30.3) | 16.0 to 42.0 |
| 55-64 | 45 | 28.0 (24.0 to 33.5) | 0.0 to 40.0 |
| 65-74 | 41 | 24.0 (19.0 to 28.0) | 0.0 to 39.0 |
| 75-84 | 44 | 23.0 (12.3 to 30.0) | 1.0 to 38.0 |
| 85+ | 32 | 15.0 (4.3 to 26.0) | 0.0 to 39.0 |
| All ages | 281 | 26.0 (19.0 to 31.0) | 0.0 to 42.0 |
| Female | |||
| 16-24 | 38 | 23.0 (20.0 to 28.3) | 10.0 to 35.0 |
| 25-34 | 39 | 32.0 (30.0 to 35.0) | 24.0 to 40.0 |
| 35-44 | 42 | 32.0 (29.0 to 34.0) | 17.0 to 40.0 |
| 45-54 | 41 | 33.0 (30.0 to 37.5) | 17.0 to 41.0 |
| 55-64 | 48 | 31.5 (28.0 to 34.0) | 14.0 to 39.0 |
| 65-74 | 47 | 30.0 (24.0 to 33.0) | 7.0 to 39.0 |
| 75-84 | 32 | 29.0 (21.3 to 32.0) | 2.0 to 38.0 |
| 85+ | 34 | 14.0 (3.0 to 24.8) | 0.0 to 35.0 |
| All ages | 321 | 30.0 (24.0 to 33.0) | 0.0 to 41.0 |
Stroke:
(Schepers et al, 2006; n = 163; mean age = 56 (11) years; 6 to 12 months post stroke, Chronic Stroke)
| 6 months post stroke | 12 months post stroke | |||||
| Measure (scale range) | Mean (SD) | Sample range | IQR | Mean (SD) | Sample range | IQR |
| FAI (0–45) | 18.0 (8.5) | 0–36 | 12–25 | 20.9 (8.7) | 2–42 | 15–28 |
| BI (0–20) | 18.7 (1.6) | 13–20 | 18–20 | 18.9 (1.5) | 14–20 | 18–20 |
| FIM total (18–126) | 111.7 (8.3) | 81 124 | 107–118 | 112.2 (8.3) | 83–125 | 109–11 |
| FIM motor (13–91) | 80.3 (6.4) | 58–91 | 77–85 | 80.9 (7.0) | 57–91 | 77–86 |
| FIM cognitive (5–35) | 31.4 (3.6) | 18–35 | 29–34 | 31.2 (3.2) | 16–35 | 30–34 |
| FAI, Frenchay Activities Index | ||||||
Elderly:
(McPhail et al, 2009; n = 40, mean age = 79 (7.3) years, Australian sample)
- Excellent test-retest reliability (ICC = 0.94 with CI 0.89 - 1.00)
(Imam & Miller, 2012)
- Excellent test-retest reliability (ICC = 0.86)
General Population
(Turnbull et al, 2000, General Population)
Excellent test-retest reliability (r = 0.96)
Lower Limb Amputation
(Miller et al, 2004, n = 84, mean age = 56.5 (13) years, Lower Limb Amputation)
- Excellent test-retest reliability (ICC = 0.79)
Stroke:
(Lu et al, 2012)
- Excellent test-retest reliability (ICC= 0.89)
(Sarker et al, 2012; n = 238, mean age = 68.6 (14.2) years, 3 months post stroke, severe (NIHSS score > 13) = 23)
- ICC= 0.27 (CI: -0.09 to 0.60) with Barthel Index
- ICC= 0.75 (CI: 0.06 to 0.91) with Nottingham Extended ADL scale
(Green et al, 2001; n = 22; mean age = 71.6 (6.8) years; mean time since stroke onset = 15 months; median time between assessments = 7 days, Chronic Stroke)
| Test-rest agreement | ||
| FAI Domain: | % agreement | Kappa |
| main meals | 100 | 1.00 |
| washing up | 77 | 0.75 |
| washing clothes | 86 | 0.82 |
| light housework | 86 | 0.84 |
| heavy housework | 82 | 0.25 |
| local shopping | 73 | 0.55 |
| social outing | 77 | 0.81 |
| walking outside >15 m | 68 | 0.53 |
| hobby | 64 | 0.50 |
| drive car/travel on bus | 82 | 0.77 |
| outings car rides | 77 | 0.82 |
| gardening | 82 | 0.74 |
| household /car maintenance | 96 | 0.69 |
| read books | 73 | 0.73 |
| paid work | 100 | * |
| *= kappa value uncertain | ||
Stroke:
(Piercy et al, 2000; n = 59; 35 = stroke survivors, 24 = caregivers; 15.2 days between assessments; mean age = 71.1 (14.8) years; stroke onset 6 to 12 months, Chronic Stroke)
- Excellent inter-rater reliability (r = 0.93; FAI total)
- Excellent item level inter-rater reliability (Kappa range = 0.64-0.80; 9/15 items)
(Post & de Witte, 2003; n = 45; mean age = 55.6 (10.9) years; 3 to 9 days between assessments, Chronic Stroke)
- Excellent interrater reliability (ICC = 0.90; FAI total)
- Adequate to excellent interrater reliability (Kappa range = 0.41 - 0.90; at item level)
(Wendel et al, 2013; n=31; mean age=75 (range 54-94); >18 months post stroke (mean =27 months), Swedish population, Swedish version)
| Distribution of FAI agreement of two raters | |
| FAI Domain | Weighted kappa |
| Main meals | 0.976 |
| Washing up | 0.908 |
| Washing clothes | 1.000 |
| Light housework | 0.956 |
| Heavy housework | 0.844 |
| Local shopping | 0.819 |
| Social outings | 0.975 |
| Walking outdoors (>15 mins) | 1.000 |
| Pursing active interest in hobby | 0.930 |
| Outings/car rides | 0.851 |
| Gardening | 0.939 |
| Household and/or car maintenance | 0.923 |
| Reading books | 0.873 |
| Gainful work | 1.000 |
Lower Limb Amputation:
(Miller et al, 2001; n = 435; mean age = 62.0 (15.7) years, Lower Limb Amputation)
· Excellent internal consistency, (Cronbach's alpha = 0.87 post amputation)
Traumatic Limb Injury:
(Chern et al, 2014; three months post injury, n=342, mean age=43.7(18.5) years; 6 months post injury, n=1010, mean age=45.3(18.6) years; 12 months post injury, n=987, mean age=45.7(18.5); Traumatic Limb Injury, Taiwanese population, Chinese Version)
- Excellent internal consistency for three time points (Chronbach's alpha = 0.91 post injury)
Stroke:
(Lin et al, 2012, Stroke)
- Excellent internal consistency for whole test (r = 0.99)
- Cronbach's alpha = 0.81 for domestic chores domain
- Cronbach's alpha = 0.73 for work/leisure domain
Stroke & Normals:
(Schuling et al, 1993; stroke sample = 185; mean age = 76 (10.4) years; mean time since stroke onset = 26 weeks, Stroke and Normals)
- Excellent internal consistency
- (Cronbach's alpha = 0.83 - controls/normal)
- (Cronbach's alpha = 0.87 - post-stroke)
- Adequate internal consistency
- (Cronbach's alpha = 0.78 - pre-stroke retrospective reports)
Elderly:
(Imam & Miller, 2012, Elderly)
- Adequate concurrent validity with Reintegration into Normal Living index (r = 0.61)
- Adequate concurrent validity with Activities-specific Balance Confidence scale (r = 0.55)
- Adequate concurrent validity with Timed Up & Go test (r = -0.68)
Stroke:
(Wade et al, 1985; Schuling et al, 1993; Cup et al, 2003; Wu et al, 2011; n = 70; mean age = 55.5 (12.1) years; mean time post stroke = 19.9 (12.5) months, Stroke)
- Excellent concurrent validity with the Barthel Index (r = 0.66; disability scores)
- Excellent concurrent validity with the Barthel (r = 0.79)
- Excellent concurrent validity with the Euroqol (r = 0.65)
- Excellent concurrent validity with the Rankin (r = -0.80)
- Adequate concurrent validity with the Stoke Adapted Sickness Impact Profile-30 (r = -0.43)
- Excellent concurrent validity with the Modified Nottingham Extended ADL scale (r = 0.80)
- Adequate concurrent validity with the Stroke Impact Scale Total (r = 0.50)
(Sarker et al, 2012, Stroke)
- Excellent concurrent validitiy with Barthel Index (r = 0.80)
- Excellent concurrent validity with Nottingham Extended ADL scale (r = 0.90)
Traumatic Limb Injury:
(Chern et al, 2014, Traumatic Limb Injury, Chinese Version)
- Adequate predictive validity at 3, 6, and 12 months with WHOQOL-BREF domains:
- at 3 months with WHOQOL-BREF - Physical domain (r = .39)
- at 3 months with WHOQOL-BREF - Psychology domain (r = .38)
- at 3 months with WHOQOL-BREF - Environment domain (r = .39)
- at 6 months with WHOQOL-BREF - Physical domain (r = .41)
- at 6 months with WHOQOL-BREF - Environment domain (r = .31)
- at 6 months with WHOQOL-BREF - Physical domain (r = .50)
- at 12 months with WHOQOL-BREF - Psychology domain (r = .37)
- at 12 months with WHOQOL-BREF - Social Relations domain (r = .35)
- at 12 months with WHOQOL-BREF - Environment domain (r = .37)
- Poor discriminant validity with the Emotional and Alertness Scales of Sickness Impact Profile (r = -0.15, Emotional and r = -0.14, Alertness)
- Excellent convergent validity with the Sickness Impact Profile-Home Management (r = -0.73)
- Excellent convergent validity with the Sickness Impact Profile-Body Care (r = -0.70)
- Excellent convergent validity with the Sickness Impact Profile- Mobility (r = -0.68)
- Excellent convergent validity with FIM Motor subscale (r = 0.63)
- Adequate convergent validity with the Sickness Impact Profile-Ambulation (r = -0.56)
- Adequate convergent validity with the Sickness Impact Profile-Recreation/pastimes (r = -0.47)
- Adequate convergent validity with the Sickness Impact Profile-Communication (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile-Eating (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile-Rest/Sleep (r = -0.42)
- Adequate convergent validity with the Sickness Impact Profile- Social Interaction (r = -0.39)
Stroke:
(Pedersen et al, 1997; n = 437; mean age = 73.6 (10) years; assessed 6 months post-stroke, Chronic Stroke)
- FAI and Barthel Index (BI) are complementary measures that both assess Activities of Daily Life (ADL)
- Each measure assesses different aspects of ability, the BI assesses movement and motor power functioning, the FAI assessed progressively more difficult aspects of ADL
- FAI floor effects were observed at approximately 57.5 points (FAI mean = 30.0 (11.6) points)
(Sarker et al, 2012, Stroke)
- Significantly large floor effect (19%)
Venous Leg Ulcers:
(Walters et al, 1999; n = 233, median age = 75 (range = 67-82) years, Venous Leg Ulcers)
Adequate floor effect (2.1%)- Adequate Ceiling Effect at 3 months (0.3%)
- Adequate Ceiling Effect at 6 months (3.5%)
- Adequate Ceiling Effect at 12 months (2.5%)
- Adequate Floor Effect at 3 months (7.3%)
- Adequate Floor Effect at 6 months (4.3%)
- Adequate Floor Effect at 12 months (2.4%)
- FAI (coupled with Stroke Adapted Sickness Impact Profile) detected the most patient change and had moderate effect sizes (d = 0.59) for chronic stroke patients between 6 and 12 months post stroke)
- FAI was also noted to change in the expected direction from pre-stroke, 6 months, and 12 months post-stroke
Frenchay Activities Index translations:
French (p26):
http://ift.tt/29GPVmo
Spanish (p288):
http://ift.tt/29GmchF
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