Πέμπτη 14 Ιουλίου 2016

Neurocardiology: a neurobiologist's perspective



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Cardiac autonomic control in health and disease



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Effect of sampling rate and filter settings on High Frequency Oscillation detections

High frequency oscillations (HFOs) are short, rare events with high power in approximately 80-500 Hz and have been suggested as a biomarker of epilepsy (Bragin et al., 2002; Engel et al., 2009; Wu et al., 2010; Blanco et al., 2011; Park et al., 2012; Haegelen et al., 2013; Kerber et al., 2014). Research often focuses on HFOs as a biomarker of ictal onset tissue (Cho et al., 2014; Dumpelmann et al., 2014; Malinowska et al., 2014; Okanishi et al., 2014; Gliske et al., 2016). HFOs have also been considered as a biomarker of a pre-ictal state (Pearce et al., 2013; Malinowska et al., 2014).

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Evaluation and treatment of mild traumatic brain injury through the implementation of clinical video telehealth: Provider perspectives from the Veterans Health Administration

Substantial numbers of U.S. military Veterans who served in recent conflicts experience mild traumatic brain injury. Data suggests that as many as 25% of Veterans do not have a comprehensive traumatic brain injury evaluation to determine a diagnosis and develop a plan to treat symptoms. Technologies like clinical video telehealth offer a potential means to overcome travel distance and other barriers that can impact Veteran receipt of a comprehensive traumatic brain injury evaluation after a positive screening; however, little is known about implementing clinical video telehealth in this context.

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Innovations with 3D Printing in Physical Medicine and Rehabilitation: An Analysis of the Literature

Created over 30 years ago, three dimensional printing (3DP) has recently seen a meteoric rise in interest within medicine, and the field of Physical Medicine and Rehabilitation is no exception. Also called additive manufacturing (AM), the recent increase in utilization of 3DP is likely due to lower cost printers as well as breakthroughs in techniques and processing. This thematic narrative review serves to introduce the rehabilitation professional to 3DP technology and how it is being applied to orthoses, prostheses, and assistive technology (AT).

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King Vision video laryngoscope versus Lightwand as an intubating device in adult patients with Mallampatti grade III and IV patients

Anticipated and unanticipated difficult airways are often encountered by anesthesiologists in their clinical practice. There are various devices available in such situations. We aim to compare King Vision video laryngoscope and Lightwand for their performance as an intubating device in predicted difficult intubation.

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Intraoperative cardiovascular collapse in a patient with epidermolysis bullosa

Epidermolysis bullosa (EB) is an autosomal recessive disorder that can arise in the skin and mucosal membranes spontaneously or after trauma. These patients may require anesthesia due to esophageal balloon dilatation, surgical release of contracture pseudosyndactyly, or dental procedures. However, clinicians may face with particular difficulty in these patients due to the formation of bullae followed by scar and contractures on the skin and airways. Furthermore, significant cardiovascular effects may also occur intraoperatively [1–4].

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Ultrasound-guided high-thoracic paravertebral block relieves referred pain caused by cervical spondylosis and provides stellate ganglion–blocking effect

A 71-year-old man visited our outpatient unit for pain around the back of the lower neck and scapular arch originating from cervical spondylosis, with some trigger points on the left side related to zygapophyseal joint. We obtained written informed consent and performed an ultrasound (US)–guided high-thoracic paravertebral block at the T1 level, using an M-turbo (Fujifilm Sonosite, Inc, Bothell, WA) and a microconvex array transducer (5-8 MHz, C11x; Fujifilm Sonosite, Inc). After placing the patient in a lateral decubitus position (with the side to be blocked on top), we confirmed the C7 spinous process as the most prominent point on the midline of the lower neck.

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Spinal Cord Injury - Quality of Life Self-Esteem

Acronym:
SCI-QOL Self-Esteem
Purpose:
The SCI-QOL Self-Esteem instrument assesses perceptions of personal competence in individuals with spinal cord injury (SCI).
Description:

The SCI-QOL Self-esteem measure is an item response theory (IRT)-calibrated item bank with 23 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 8 item short form (SF). 16 items were newly generated, 5 items were drawn from the Neuro-QOL measurement system and 2 items were drawn from the Traumatic Brain Injury-QOL measure.

Area of Assessment: Mental Health, Quality of Life, Self-Efficacy
Body Part: Not Applicable
ICF Domain: Body Function
Domain: Emotion
Assessment Type: Patient Reported Outcomes
Length of Test: 05 Minutes or Less
Time to Administer:
<5 Minutes
Number of Items: There are 23 items in the entire item bank. The short form has 8 items. The CAT can present 4-12 items, depending on the user's time vs. accuracy preferences.
Equipment Required:

The Short Form (SF) version requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to AssessmentCenter.net.

Access to the short form, and administration of CATs through Assessment Center, is available through SCI-QOL@udel.edu.

Training Required:
SCI-QOL Self-esteem article (Kalpakjian et al., 2015) and, if administering CATs, Assessment Center User Manual.
Type of training required: Reading an Article/Manual
Cost: Free
Actual Cost:
Free
Age Range: Adult: 18-64 years, Elderly adult: 65+
Administration Mode: Computer
Diagnosis: Spinal Cord Injury
Populations Tested:
Spinal Cord Injury
Standard Error of Measurement (SEM):
Depends upon mode of administration (Standard Error = SE)
  • Full Item Bank: Mean SE= 0.22 (Range= 0.14--.51)
  • 8-Item Fixed CAT: Mean SE= 0.27 (Range= 0.19-0.54)
  • Variable Length CAT: Mean SE= 0.31 (0.24-0.53) 
Minimal Detectable Change (MDC):
Calculated Using Mean SEM:
  • Full Item Bank: MDC= 10.7
  • 8-Item Fixed CAT: MDC= 10.62
  • Variable Length CAT: MDC= 10.61
Minimally Clinically Important Difference (MCID):
Not Established
Cut-Off Scores:
Not Established
Normative Data:
 
Test-retest Reliability:

Traumatic SCI (Kalpakjian et al., 2015; n= 245)

  • Excellent: (ICC= 0.84)
Interrater/Intrarater Reliability:
Not Applicable
Internal Consistency:
Traumatic SCI (Kalpakjian et al., 2015; n= 717; Mean Age= 43, SD= 15.3; Time Post Injury= 7.1, SD=10; 45% Paraplegia, 55% Tetraplegia)
  • Excellent: (ICC= 0.95)
Criterion Validity (Predictive/Concurrent):
Not Established
Construct Validity (Convergent/Discriminant):
Not Established
Content Validity:
Items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI care (n=42) (Tulsky et al., 2011).
Face Validity:
Not Statistically Assessed
Floor/Ceiling Effects:
Traumatic SCI (Kalpakjian et al., 2015; n= 717; Mean Age= 43, SD= 15.3; Time Post Injury= 7.1, SD=10; 45% Paraplegia, 55% Tetraplegia)
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (4.3%)
Responsiveness:
Not Established
Considerations:
None
Bibliography:
Kalpakjian, C.Z., Tate, D.G., Kisala, P.A., & Tulsky, D.S. (2015). Measuring self-esteem after spinal cord injury: Development, validation, and psychometric characteristics of the SCI-QOL Self-Esteem item bank and short form. Journal of Spinal Cord Medicine, 38(3), 377-385.
 
Tulsky, D.S., Kisala, P.A., Victorson, D. Tate, D., Heinemann, A.W., Amtmann, D., & Cella, D. (2011). Developing a contemporary patient-reported outcomes measure for spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92(10), S44-S51.
 
Year published: 2015
Instrument in PDF Format: Yes


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Spinal Cord Injury - Quality of Life Positive Affect & Well Being

Acronym:
SCI-QOL Positive Affect & Well Being
Purpose:
The SCI-QOL Positive Affect & Well Being instrument assesses aspects that relate to a sense of well-being, life satisfaction and sense of purpose.
Description:

The SCI-QOL Positive Affect & Well-being instrument is an item response theory (IRT)-calibrated item bank with 28 items that is available for administration as a computer adaptive test (CAT; range 4-12 items) or 10 item short form (SF). 5 items were newly generated and 23 were drawn from the Neuro-QOL positive affect and well-being scale.

Area of Assessment: Mental Health, Positive Affect, Quality of Life
Body Part: Not Applicable
ICF Domain: Body Function
Domain: Emotion
Assessment Type: Patient Reported Outcomes
Length of Test: 05 Minutes or Less
Time to Administer:
<5 Minutes
Number of Items: There are 28 items in the entire item bank. The short form has 10 items. The CAT can present 4-12 items, depending on the user's time vs. accuracy preferences.
Equipment Required:
The Short Form (SF) version requires only the printed form and a pencil. A CAT administration requires a desktop, laptop, or tablet computer with internet connection and login to AssessmentCenter.net.
 
Access to the short form, and administration of CATs through Assessment Center, is available through SCI-QOL@udel.edu.  
Training Required: Yes. SCI-QOL PAWB article (Bertisch et al., 2015) and, if administering CATs, the Assessment Center User Manual.
Type of training required: Reading an Article/Manual
Cost: Free
Actual Cost:
Free
Age Range: Adult: 18-64 years, Elderly adult: 65+
Administration Mode: Computer
Diagnosis: Spinal Cord Injury
Populations Tested:
Spinal Cord Injury
Standard Error of Measurement (SEM):
Depends upon mode of administration:
  • Full Item Bank: Mean SEM= 0.14 (Range= 0.10-0.45)
  • 10-Item Short Form: Mean SEM= 0.21 (Range= 0.14 - 0.48)
  • 10-Item Fixed CAT: Mean SEM= 0.19 (Range= 0.13-0.47)
  • Variable-length CAT: Mean SEM= 0.20 (Range= 0.15 - 0.46)
  • Variable Length CAT (Min 4): Mean SEM= 0.25 (0.20-0.46) 
Minimal Detectable Change (MDC):
Calculated Using Mean SEM at 95% Confidence Interval:
  • Full Item Bank: MDC= 0.39
  • 10-Item Fixed CAT: MDC= 0.53
  • Variable Length CAT (Min 4): MDC= 0.69
Minimally Clinically Important Difference (MCID):
Not Established
Cut-Off Scores:
Not Established
Normative Data:
(n=717, Mean Age= 43, SD= 15.3; Time Post Injury= 7.1, SD=10; 45% Paraplegia, 55% Tetraplegia)
Test-retest Reliability:
Traumatic SCI (Bertisch et al., 2015)
  • Excellent: (Pearson's r= 0.78)
  • Excellent: (ICC= 0.78)
Interrater/Intrarater Reliability:
Not Applicable
Internal Consistency:
Traumatic SCI (Bertisch et al., 2015)
  • Full Item Bank - Excellent: (Cronbach's Alpha= 0.97)
Criterion Validity (Predictive/Concurrent):
Not Established
Construct Validity (Convergent/Discriminant):
Not Established
Content Validity:
Items were derived from focus groups and interviews with individuals with traumatic SCI (n=65) and clinicians who specialize in SCI care (n=42) (Tulsky et al., 2011).
Face Validity:
Not statistically assessed, but
Floor/Ceiling Effects:
Traumatic SCI (Bertisch et al., 2015
 
Full Item Bank:
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (3.1%)
10-Item Short Form:
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (9.9%)
10-Item Fixed-length CAT:
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (4.5%)
Variable-length CAT (Min 8):
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (3.49%)
Variable-length CAT (Min 4):
  • Floor Effect: Excellent (0.14%)
  • Ceiling Effect: Adequate to Excellent (3.5%)
Responsiveness:
Not Established
Considerations:
None
Bibliography:
Bertisch, H., Kalpakjian, C.Z., Kisala, P.A. & Tulsky, D.S. (2015). Measuring positive affect and well-being after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Positive Affect and Well-being item bank and short form. Journal of Spinal Cord Medicine, 38(3), 356-365.
 
Tulsky, D.S., Kisala, P.A., Victorson, D. Tate, D., Heinemann, A.W., Amtmann, D., & Cella, D. (2011). Developing a contemporary patient-reported outcomes measure for spinal cord injury. Archives of Physical Medicine and Rehabilitation, 92(10), S44-S51.
Year published: 2015
Instrument in PDF Format: Yes


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Chedoke Arm and Hand Activity Inventory - 7

Acronym:
CAHAI - 7
Purpose:
The purpose of this measure is to evaluate the functional ability of the paretic arm and hand to perform tasks.
Description:

The CAHAI is a performance test using functional items. It is not designed to measure the client's ability to complete the task using only their unaffected hand, but rather to encourage bilateral function.

This test consists of 13 functional tasks to complete (open jar of coffee, call 911, draw a line with a ruler, put toothpaste on toothbrush, cut medium consistency putty, pour a glass of water, wring out washcloth, clean pair of eyeglasses, zip up a zipper, do up 5 buttons, dry back with towel, place container on table, carry bag upstairs).

Area of Assessment: Activities of Daily Living, Upper Extremity Function
Body Part: Upper Extremity
ICF Domain: Activity
Domain: ADL, Motor
Assessment Type: Performance Measure
Length of Test: 06 to 30 Minutes
Time to Administer:
30 mintues.
Number of Items: 13
Equipment Required:
  • Jar of coffee
  • Phone
  • Ruler and pen
  • Toothpaste and toothbrush
  • Knife
  • Fork
  • Putty
  • Glass of water
  • Wet washcloth
  • Eyeglasses
  • Jacket and zipper
  • Shirt with 5 buttons
  • Towel
  • Rubbermaid 38 liter container (50x37x27cm) with 10 lb. weight
  • Plastic gorcery bag with 4 lb. weight
Training Required:
Read the administration and scoring manual
Type of training required: reading an article/manual
Cost: Free
Actual Cost:
$0.00
Administration Mode: Paper/Pencil
Diagnosis: Movement Disorders
Populations Tested:
Upper Extremity Paralysis
Stroke (inpatient and outpatient)
Standard Error of Measurement (SEM):
Not Established.
Minimal Detectable Change (MDC):
Upper Extremity Paralysis
 
(Barreca et al, 2005)
  • MDC (90) = 6.3 points
Minimally Clinically Important Difference (MCID):
Not Established.
Cut-Off Scores:
Not Established.
Normative Data:
Not Established.
Test-retest Reliability:
Upper Extremity Paralysis:
 
("Psychometric properties: Reliability")
  • Excellent reliability (ICC = 0.96)
Interrater/Intrarater Reliability:

Stroke: (Schuster, 2010; n = 23 patients (Mean age 69.4, SD 12.9: 6 females; Mean time post-stroke: 1.5y (2.5y))

  • Excellent reliability (ICC = ranges from 0.96-0.99 for CAHAI-G 13, 9, 8, 7)

Upper Extremity Paralysis:

 
(Barreca et al, 2005)
  • Excellent reliability (ICC = 0.98)
Internal Consistency:
Upper Extremity Paralysis:
 
("Psychometric properties: Reliability")
  • Excellent reliability (ICC = 0.95)

Stroke:

  • Excellent reliability (ICC = 0.967)
Criterion Validity (Predictive/Concurrent):
Not Established.
Construct Validity (Convergent/Discriminant):
Not Established.
Content Validity:
Not Established.
Face Validity:
Not Established.
Floor/Ceiling Effects:
Not Established.
Responsiveness:
Not Established.
Considerations:
  • Client should have some active movemtn capacity in the involved arm
  • All three shortened versions of the CAHAI-13 demonstrated strong psychometric properties and can be used as a functional measure for assessment for UE function (especially with limited time and resources). The CAHAI-7 maintained the highest level of longitudinal validity and cross-sectional validity.
  • CAHAI is inexpensive and transportable compared to the ARAT. Whereas the ARAT bilaterally examines upper limb function, the CAHAI takes a bilateral approach to analyzing basic functional tasks.
Bibliography:

Barreca, S., Gowland, C. K., et al. (2004). "Development of the Chedoke Arm and Hand Activity Inventory: theoretical constructs, item generation, and selection." Top Stroke Rehabil 11(4): 31-42. Find it on PubMed

Barreca, S. R., Stratford, P. W., et al. (2005). "Test-retest reliability, validity, and sensitivity of the Chedoke arm and hand activity inventory: a new measure of upper-limb function for survivors of stroke." Arch Phys Med Rehabil 86(8): 1616-1622. Find it on PubMed 

Schuster, C., Hahn, S. & Ettlin, T. (2010). Objectively-assessed outcome measures: a translation and cross-cultural adaptation procedure applied to the Chedoke McMaster Arm and Hand Activity Inventory (CAHAI). BMC Medical Research Methodology, 10, 106. Find it on PubMed 

Year published: 2013
Instrument in PDF Format: Yes


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Neck Disability Index

Link to instrument: Access Neck Disability Index Here
Acronym:
NDI
Purpose:
The Neck Disability Index (NDI) is a self-report questionnaire used to determine how neck pain affects a patient's daily life  and to assess the self-rated disability of patients with neck pain.
Description:

Originally developed in 1991, the NDI is now the most widely used instrument for assessing self-rated disability in patients with neck pain.

  • The NDI consists of ten questions in the following domains: Pain Intensity, Personal Care, Lifting, Reading, Headaches, Concentration, Work, Driving, Sleeping, and Recreation.
  • Scoring: Each question contains six answer choices, scored from 0 (no disability) to 5 (complete disability). All section scores are then totaled. Scoring is reported on a 0-50 scale, 0 being the best possible score and 50 being the worst. Alternately, the score can be reported from 0-100. The score is often reported as a percentage (0-100%)
Area of Assessment: Activities of Daily Living, Attention and Working Memory, Functional Mobility, Life Participation, Occupational Performance, Pain, Quality of Life, Sleep
Body Part: Neck
ICF Domain: Body Function, Activity, Participation
Domain: ADL, Motor, Sensory
Assessment Type: Patient Reported Outcomes
Length of Test: 05 Minutes or Less
Time to Administer:
5 minutes
Number of Items: 10-items
Equipment Required:
Pen or pencil
Copy of outcome measure
Training Required:
No training is required to administer the NDI
Type of training required: No Training
Cost: Free
Actual Cost:
Free
Age Range: Adult: 18-64 years, Elderly adult: 65+
Administration Mode: Paper/Pencil
Diagnosis: Neck Injury, Pain
Populations Tested:
  • Cervical Radiculopathy (CR)
  • Mechanical Neck Pain (MNP)
  • Neck pain: Chronic, non-specific
  • Neck pain: Chronic, non-traumatic
  • Neck pain: Chronic, uncomplicated
  • Neck pain: Degenerative, post-traumatic and other
  • Neck pain: Mechanical
  • Neck pain: With or without arm pain
  • Patients undergoing cervical fusion surgery for degenerative disc disease
  • Symptomatic cervical disc disease involving one vertebral level between C3 and C7
  • Subacute whiplash
  • Whiplash Associated Disorders (WAD)
Standard Error of Measurement (SEM):

Cervical Radiculopathy:

(Cleland et al, 2006; n = 38; mean age = 51.2 (10.6) years

  • SEM = 4.4 (on a scale of 0 - 50)

(Young et al, 2010; n = 165; mean age = 49 (9.7) years)

  • SEM = 5.7 (on a scale of 0 - 50)

Mechanical Neck Disorder:

(Cleland et al, 2008; n = 138; mean age = 42.5 (11.9) years

  • SEM = 8.4 (on a scale of 0 - 50)

(Young et al, 2009; n = 91; mean age = 47.8 (14.6) years

  • SEM = 4.3 (on a scale of 0 - 50)

Non-Specific Neck Pain:

(Jorristsma et al, 2012; n = 76; mean age = 38.5 years)

  • SEM = 3.0 (on a scale of 0 - 50)
Mixed NSNP:

(Vos C.J., Verhagen A.P., Koes B.W., 2006; n = 187)

  • SEM = 0.60 (WAD, arm pain, shoulder pain, headaches)

(Westaway M.D., Stratford P.W., Binkley J.M., 1998; n = 31, average age = 40.4)

  • SEM = 1.80 (torticollis, radiologically confirmed osteoarthritis, radicular findings, history of MVA)
Minimal Detectable Change (MDC):

Mechanical Neck Disorders

(Cleland et al, 2008)

  • MDC = 19.6% (on a scale of 0 - 100%)

(Young et al, 2009)

  • MDC = 10.2 (on a scale of 0 - 50)

Cervical Radiculopathy:

(Cleland et al, 2006)

  • MDC = 10.2 (on a scale of 0 - 50)

(Young et al, 2010)

  • MDC = 13.4 (on a scale of 0 - 50)

Non-specific Neck Pain:

(Pool et al, 2007; n = 183; mean age = 45.8 (11.6) years)

  • MDC = 10.5 calculated (on a scale of 0 - 50)

(Jorristsma et al, 2012)

  • MDC = 8.4 (on a scale of 0 - 50)

CR:

(Young I.A., Cleland J.A., Michener L.A., Brown C., 2010)

  • MDC = 13.4

(Cleland J.A., Fritz J.M., Whitman J.M., Palmer J.A., 2006; n = 38)

  • MDC = 10.2

Mixed NSNP:

(Pool J.J., Ostelo R.W., Hoving J.L., Bouter L.M., de Vet H.C., 2007; n = 183)

  • MDC = 10.5

(Vos C.J., Verhagen A.P., Koes B.W., 2006)

  • MDC = 1.66 (WAD, arm pain, shoulder pain, headaches)

(Westaway M.D., Stratford P.W., Binkley J.M., 1998)

  • MDC = 4.20 (torticollis, radiologically confirmed osteoarthritis, radicular findings, history of MVA)
Minimally Clinically Important Difference (MCID):

Mechanical Neck Disorders:

(Young et al, 2009)

  • MCID = 7.5 (on a scale of 0 - 50)

(Cleland et al, 2008)

  • MCID = 19% (on a scale of 0 - 100%)

(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)

  • MCID = 5.0

Cervical Radiculopathy:

(Young et al, 2010)

  • MCID = 8.5 (on a scale of 0 - 50)

(Cleland et al, 2006)

  • MCID = 7.0 (on a scale of 0 - 50)

Non-specific Neck Pain:

(Pool et al, 2007)

  • MCID = 3.5

(Jorristsma et al, 2012)

  • MCID = 3.5 (on a scale of 0 - 50)

Cervical Spine Fusion:

(Carreon et al, 2010; n = 505; mean age = 52.6 (10.2) years)

  • MCID = 7.5 (on a scale of 0 - 50)
Cut-Off Scores:
Not Established
Normative Data:
Not Established
Test-retest Reliability:

Mechanical neck disorders:

(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)

  • r = 0.94

(Ackelman B.H., Lindgren U., 2002; n = 97)

  • r = 0.81 – 0.99

(Vernon H., Mior S., 1991)

  • r = 0.89 

(Young et al, 2009)

  • Adequate test retest reliability (ICC = 0.64)
  • According to Hogg-Johnson (2009), the low test retest reliability in this study, when compared to other studies, could be due to the inclusion criteria or due to methodological problems. Precision of the estimate could also have been affected by small sample size or the study's definition of a 'stable' sample.

Cervical Radiculopathy:

(Young et al, 2010)

  • Adequate test retest reliability (ICC = 0.55)

Neck Pain: Mechanical:

(Cleland et al, 2008)

  • Adequate test retest reliability (ICC = 0.50)

Neck Pain:

(Westaway M.D., Stratford P.W., Binkley J.M., 1998)

  • ICC = 0.89 (included torticollis, radiologically confirmed osteoarthritis, radicular findings ,and patients with a history of MVA)

(Vos C.J., Verhagen A.P., Koes B.W., 2006)

  • ICC = 0.90 (23% had WAD, 37% had 'arm pain', 56% had 'shoulder pain', and 62% had headaches)

(Shaheen et al, 2013; n = 65, mean age = 41.3 (10.2) years)

  • Excellent test retest reliability (ICC = 0.96)

Cervical Radiculopathy:

(Cleland et al, 2006)

  • Adequate test retest reliability (ICC = 0.68)

Neck Pain: Degenerative, post-traumatic and other:

(McCarthy et al, 2007; n = 160 patients attending the Spinal Out-Patients Department at Queen's Medical Centre in Nottingham, UK; mean age = 51.2 (14-93 years); sex = 64 males and 96 females; 34 patients completed a survery 2 weeks later; average NDI score = 46%)

  • Excellent test retest reliability (ICC = 0.93)

Neck Pain: Chronic, non-specific:

(Jorristsma et al, 2012)

  • Excellent test retest reliability (ICC = 0.86)

Patients who underwent cervical fusion for degenerative disorders:

(Carreon et al, 2010)

  • Excellent test retest reliability (ICC = 0.90 to 0.93)
Interrater/Intrarater Reliability:
Not Established
Internal Consistency:

Neck pain: Chronic, uncomplicated:

(Gay et al, 2007; n = 23; mean age = 49.6 (14.6) years)

  • Adequate internal consistency (Cronbach alpha= 0.72 pretreatment and 0.77 post-treatment)

Neck Pain:

(Shaheen et al, 2013)

  • Excellent internal consistency (Cronbach alpha= 0.89)

Neck Pain: Degenerative, post-traumatic and other:

(McCarthy et al, 2007;  n = 160; mean age = 51.2 years)

  • Excellent internal consistency (Cronbach alpha= 0.864)

Patients who underwent cervical fusion for degenerative disorders:

(Carreon et al, 2010)

  • Adequate to Excellent internal consistency (Cronbach alpha ranged from 0.74 – 0.93)

Subacute whiplash patients with neck pain:

(Nieto et al, 2008; n =150; mean age = 35 (11.13) years)

  • Excellent internal consistency (Cronbach alpha= 0.87)

Neck pain: Mechanical, non-specific:

(Van Der Velde et al, 2009; n = 521 subjects with neck pain; mean age = 44.95 (11.50 years); sex = 338 women and 183 men; mean neck pain intensity in week prior to study = 5.17 (1.87); mean NDI score = 13.57 (5.75))

  • Adequate internal consistency (Cronbach alpha ranged from 0.73 - 0.80)
(Hains F., Waalen J., Mior S., 1998; n = 237)
  • Cronbach's alpha = 0.92

Whiplash

(Vernon H., Mior S., 1991)

  • Cronbach's alpha = 0.80
Criterion Validity (Predictive/Concurrent):

Cervical Fusion for Degenerative Disorders Population:

(Carreon et al, 2011; n = 2080 patients undergoing cervical fusion for degenerative disorders; NDI scores were collected before surgery and 12 and 24 months after surgery; sex = 33% male; mean age = 50.4 (11.0) years)

  • Excellent concurrent validity with SF - 6D (r = 0.82)
  • Excellent predictive validity with SF - 6D (r = 0.81)

General Neck Pain Population:

(McCarthy et al, 2007)

  • Adequate to Excellent concurrent validity with SF - 36 (r = 0.45 to 0.74)

Subacute Whiplash Patients with Neck Pain:

(Nieto et al, 2008)

  • Adequate concurrent validity with pain intensity (r = 0.51)
  • Adequate concurrent validity with pain interference index (r = 0.50)
  • Adequate concurrent validity with depression scale (r = 0.51)
Construct Validity (Convergent/Discriminant):

Mechanical Neck Disorders:

(Young et al, 2009)

  • Adequate construct validity with global rating of change (r = 0.52)

Young (2010):

  • Examined by comparing baseline scores and follow-up scores for stable and unstable groups using 2-way ANOVA. Showed significant change (P<0.001) in disability among self-rating patients.

(Shaheen A.A., Omar M.T., Vernon H., 2013)

  • Strong correlation with GRC: r = 0.81

Cervical Radiculopathy (CR)

(Cleland J.A., Fritz J.M., Whitman J.M., Palmer J.A., 2006)

  • Poor construct validity

Neck pain: Chronic, uncomplicated:

Gay (2007):

  • Adequate construct validity with the VAS (r=0.45)
  • Excellent construct validity with the NBQ on pre and posttest respectively (r=0.8 and 0.77 respectively)

(McCarthy M.J., Grevitt M.P., Silcocks P., Hobbs G., 2007)

  • Correlation with SF-36 (each of the eight domains): r = -0.45 to -0.76 (spinal surgery outpatient setting)

(Riddle D.L., Stratford P.W., 1998; n = 146)

  • Adequate correlation with Mental Component Summary (MCS) of SF-36: r = 0.47
  • Adequate correlation with  Physical Component Summary (PCS) of SF-36: r = 0.53

(Westaway M.D., Stratford P.W., Binkley J.M., 1998)

  • Correlation with Patient-Specific Functional Scale (PSFS): r = 0.73 (at admission)
  • r = 0.81 (at discharge)

Neck Pain: Chronic, non-traumatic:

Chan Ci En (2009, n = 20; mean age = 64.5 (12.8) years):

  • Excellent construct validity with the NPAD (r= 0.86)

Neck Pain: With or without radiation to arm:

Alliet (2013; n = 338; mean age = 41.3 (11.8) years):

  • Excellent construct validity with the DASH (r= 0.75)

Whiplash-associated disorders:

Hoving (2003, n = 71; mean age = 40.1 (14.3) years)

  • Excellent construct validity with the NPQ (r =0.88)

Symptomatic cervical disc disease:

Richardson (2011, n = 430; mean age = 43.2 (7.9) years):

  • Excellent construct validity with the SF-6D for all tested algorithms (r= >0.82).

 

Content Validity:

Whiplash associated disorders:

(Hoving et al, 2003)

  • The NDI and NPQ do not assess the full range of disabilities indicated as important to the patient in the PET. Of the 9 problems most frequently identified by the PET, only 3 are measured by the NDI (work, driving, and sleeping) and 4 by the NPQ (work, driving, sleeping, and social activities.) Other problems such as emotional and social functioning are not addressed by the NDI or NPQ

Neck Pain: Chronic, non-traumatic:

(Chan Ci En et al, 2009)

  • Of the 11 problems identified by the majority of subjects in the PET, the NDI contained 6 of these problems and the NPAD contained 7

Neck Pain: With or without radiation to arm:

(Ailliet et al, 2013)

  • Review of the literature and personal communication with the developer of the NDI confirmed that the NDI was based on the concept of disability; 11 neck pain experts and 10 patients commented on the construct, comprehensiveness, and relevance of the NDI

Subacute whiplash patients with neck pain:

(Nieto et al, 2008)

  • Based on factor analysis the NDI can be viewed as a two-factor instrument. It can be broken down to pain intensity and interference with the level of cognitive functioning as well as interference with the level of physical functioning
Face Validity:

Neck Pain: With or without radiation to arm:

(Ailliet et al, 2013)

  • Reviewed with 10 patients, who commented on construct, comprehensiveness, and relevance of NDI
Floor/Ceiling Effects:

Neck Pain: With or without radiation to arm:

(Ailliet et al, 2013)

  • Propose that a 10 - item computerized adaptive test can make it so that ceiling and floor effects are very unlikely to occur in the clinical applications (alternative to NDI)

Neck pain: Chronic, uncomplicated:

(Gay et al, 2007)

  • There were no apparent floor or ceiling effects for either the NDI or the NBQ

Whiplash associated disorders:

(Hoving et al, 2003)

  • The overall scores for the NDI and NPQ showed no floor/ceiling effects. However, ceiling effects existed for some individual items on the NDI

Symptomatic cervical disc disease:

(Richardson et al, 2011)

  • Ceiling and floor effects were generated in the utility scores: >0.9 or <0.2

Neck Pain:

(Shaheen et al, 2013)

  • No floor/ceiling effects as less than 15% of patients achieved the minimum possible scores
Responsiveness:

Mechanical Neck Pain

(Cleland J.A., Childs J.D., Whitman J.M., 2008)

  • AUC = 0.83, acceptable 

(Stratford P.W., Riddle D.L., Binkley J.M., Spadoni G., Westaway M.D., Padfield B., 1999)

  • AUC = 0.9, acceptable 

(Jorritsma W., Dijkstra P.U., de Vries G.E., Geertzen J.H., Reneman M.F., 2012)

  • AUC = 0.75, acceptable

(Young B.A., Walker M.J., Strunce J.B., Boyles R.E., Whitman J.M., Childs J.D., 2009)

  • AUC = 0.79, acceptable 

Neck pain: Chronic, uncomplicated:

(Gay et al, 2007)

  • Large effect size = 1.12

Mechanical Neck Disorders:

(Cleland et al, 2008)

  • Moderate responsiveness; NDI and GRCS (r = 0.58), NDI and NRS (r = 0.57)

Neck Pain:

(Shaheen et al, 2013)

  • Responsiveness was calculated by comparing change in NDI scores between improved and stable patients 1 week post treatment
  • The results were statistically significant (P < 0.05)

Cervical Radiculopathy:

(Young I.A., Cleland J.A., Michener L.A., Brown C., 2010)

  • AUC = 0.74, acceptable

(Cleland et al, 2006)

  • AUC = 0.57 indicating an "inability to identify changes in patient's perceived levels of disability when such a change had occurred"
  • Correlation between change scores on NDI and GROC and NPRS was not significant

Cervical Fusion for Degenerative Disorders Population:

(Carreon et al, 2010)

  • Excellent responsiveness (Effect size = 0.85)
Considerations:

(Young et al, 2009)

Consider NDI changes of 10 points to be clinically meaningful for patients presenting with mechanical neck pain both with and without concurrent UE symptoms.

(Young et al, 2010)

Consider NDI changes of 13 points to be clinically meaningful for patients presenting with cervical radiculopathy.

(Richardson et al, 2011)

Translational healthcare economic models demonstrate that NDI scores are predictive of SF-6D utility scores in patients receiving either a total disc arthroplasty or anterior cervical discectomy and fusion for treatment of symptomatic cervical disc disease involving one vertebral level between C3 and C7. Utility scores derived from the NDI may be useful in making cost-effective choices in guiding evidence based care among and between healthcare disciplines.

(Jorritsma et al, 2012)

Clinicians should be aware that choosing either the minimal detectable change (MDC) or the minimal important change (MIC) gives different cut-off values and amounts of certainty on whether the observed change is relevant in patients with non-specific neck pain of duration greater than 3 months. Of the two options, application of the MDC is the more conservative choice. Thus, the use of MDC over the MIC increases the certainty that the observed change score is relevant and larger than measurement error.

(Aillet et al, 2013)

Sports and computer work are important aspects to consider in regards to the modern disablement process of neck pain. These components are not addressed by the NDI, which suggests the NDI may be an incomplete primary outcome measure.

(Alliet et al, 2013)

Medication use can have an impact on the scoring of the different items of the NDI and also on the interpretation of the score. Medication use is not addressed by the NDI, which suggests the NDI may be an incomplete primary outcome measure.

(Hoving et al, 2003, Neito et al, 2008, Chan Ci En et al, 2009)

Several relevant items, such as social and emotional items, of whiplash-associated disorders are out of the scope of the NDI. This suggests the NDI may be an incomplete primary outcome measure in the whiplash-associated disorder population.

(Carreon et al, 2010)

The change in NDI score at which a cervical spine fusion patient will perceive a marked improvement, compared to before surgery, is a 10 point decrease.

(Shaheen et al, 2013)

Missing data for driving (item 8) occurs with a high frequency. This may be due to the fact that driving is restricted to certain genders in certain cultures. Cultural factors should be considered when selecting the NDI as a primary outcome measure.

(Nieto et al, 2008)

The NDI demonstrates a two factor structure in the whiplash-associated disorder population. The first factor, referred to as "pain and interference with cognitive functioning", encompasses the following items: neck pain intensity, reading, headaches, concentration, and sleeping. This factor alludes to the extent to which neck pain interferes with a person's cognitive functioning. The second factor, referred to as "functional disability", encompasses the following items: personal care, lifting, work, driving, and recreation. This second factor refers to the extent to which neck pain influences the performance of a person's usual physical activity.

Bibliography:

Ailliet, L., Knol, D. L., et al. (2013). "Definition of the construct to be measured is a prerequisite for the assessment of validity. The Neck Disability Index as an example." J Clin Epidemiol 66(7): 775-782 e772. Find it on PubMed

Carreon, L. Y., Anderson, P. A., et al. (2011). "Predicting SF-6D utility scores from the neck disability index and numeric rating scales for neck and arm pain." Spine (Phila Pa 1976) 36(6): 490-494. Find it on PubMed

Carreon, L. Y., Glassman, S. D., et al. (2010). "Neck Disability Index, short form-36 physical component summary, and pain scales for neck and arm pain: the minimum clinically important difference and substantial clinical benefit after cervical spine fusion." Spine J 10(6): 469-474. Find it on PubMed

Childs, J. D., Cleland, J. A., et al. (2011). "Neck pain: clinical practice guidelines linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association." Journal of Women's Health Physical Therapy 35(2): 57-90.

Cleland, J. A., Childs, J. D., et al. (2008). "Psychometric properties of the Neck Disability Index and Numeric Pain Rating Scale in patients with mechanical neck pain." Arch Phys Med Rehabil 89(1): 69-74. Find it on PubMed 

Cleland, J. A., Fritz, J. M., et al. (2006). "The reliability and construct validity of the Neck Disability Index and patient specific functional scale in patients with cervical radiculopathy." Spine (Phila Pa 1976) 31(5): 598-602. Find it on PubMed

En, M. C., Clair, D. A., et al. (2009). "Validity of the Neck Disability Index and Neck Pain and Disability Scale for measuring disability associated with chronic, non-traumatic neck pain." Man Ther 14(4): 433-438. Find it on PubMed

Gay, R. E., Madson, T. J., et al. (2007). "Comparison of the Neck Disability Index and the Neck Bournemouth Questionnaire in a sample of patients with chronic uncomplicated neck pain." J Manipulative Physiol Ther 30(4): 259-262. Find it on PubMed

Hogg-Johnson, S. (2009). "Differences in reported psychometric properties of the Neck Disability Index: patient population or choice of methods?" Spine J 9(10): 854-856. Find it on PubMed

Hoving, J. L., O'Leary, E. F., et al. (2003). "Validity of the neck disability index, Northwick Park neck pain questionnaire, and problem elicitation technique for measuring disability associated with whiplash-associated disorders." Pain 102(3): 273-281. Find it on PubMed

Howell, E. R. (2011). "The association between neck pain, the Neck Disability Index and cervical ranges of motion: a narrative review." J Can Chiropr Assoc 55(3): 211-221. Find it on PubMed

Jorritsma, W., Dijkstra, P. U., et al. (2012). "Detecting relevant changes and responsiveness of Neck Pain and Disability Scale and Neck Disability Index." Eur Spine J 21(12): 2550-2557. Find it on PubMed

McCarthy, M. J., Grevitt, M. P., et al. (2007). "The reliability of the Vernon and Mior neck disability index, and its validity compared with the short form-36 health survey questionnaire." Eur Spine J 16(12): 2111-2117. Find it on PubMed

Nieto, R., Miro, J., et al. (2008). "Disability in subacute whiplash patients: usefulness of the neck disability index." Spine (Phila Pa 1976) 33(18): E630-635. Find it on PubMed

Pool, J. J., Ostelo, R. W., et al. (2007). "Minimal clinically important change of the Neck Disability Index and the Numerical Rating Scale for patients with neck pain." Spine (Phila Pa 1976) 32(26): 3047-3051. Find it on PubMed

Richardson, S. S. and Berven, S. (2012). "The development of a model for translation of the Neck Disability Index to utility scores for cost-utility analysis in cervical disorders." Spine J 12(1): 55-62. Find it on PubMed

Rodine, R. J. and Vernon, H. (2012). "Cervical radiculopathy: a systematic review on treatment by spinal manipulation and measurement with the Neck Disability Index." J Can Chiropr Assoc 56(1): 18-28. Find it on PubMed

Shaheen, A. A., Omar, M. T., et al. (2013). "Cross-cultural Adaptation, Reliability, and Validity of the Arabic Version of Neck Disability Index in Patients With Neck Pain." Spine (Phila Pa 1976) 38(10): E609-615. Find it on PubMed

van der Velde, G., Beaton, D., et al. (2009). "Rasch analysis provides new insights into the measurement properties of the neck disability index." Arthritis Rheum 61(4): 544-551. Find it on PubMed

Vernon, H. (2008). "The Neck Disability Index: state-of-the-art, 1991-2008." J Manipulative Physiol Ther 31(7): 491-502. Find it on PubMed

Young, B. A., Walker, M. J., et al. (2009). "Responsiveness of the Neck Disability Index in patients with mechanical neck disorders." Spine J 9(10): 802-808. Find it on PubMed

Year published: 1991
Instrument in PDF Format: Yes


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Frenchay Activities Index

Acronym:
FAI
Purpose:

Assesses a broad range of activities of daily living in patients recovering from stroke

Description:
  • 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:
  1. Domestic chores
  2. Leisure/work
  3. Outdoor activities
The frequency with which each item or activity is undertaken over the past 3 or 6 months (depending on the nature of the activity) is assigned a score of 1 – 4 where a score of 1 is indicative of the lowest level of activity The scale provides a summed score from 15 – 60 A modified 0-3 scoring system introduced by Wade et al. (1985) yields a score of 0 – 45
Area of Assessment: Activities of Daily Living
Body Part: Not Applicable
ICF Domain: Activity, Participation
Domain: ADL
Assessment Type: Patient Reported Outcomes
Length of Test: 05 Minutes or Less
Time to Administer:
5 minutes
Number of Items: 15
Equipment Required:
None necessary
Training Required:
None necessary
Type of training required: No Training
Cost: Free
Actual Cost:
Free
Age Range: Adult: 18-64 years, Elderly adult: 65+
Administration Mode: Paper/Pencil
Diagnosis: Geriatrics, Lower Limb Amputation, Stroke
Populations Tested:
  • Lower Limb Amputation
  • Stroke
  • Venous Leg Ulcers
  • Chronic Low Back Pain
  • High Utilizers of Health Care
  • Mild Cognitive Impairment
  • Traumatic Limb Injury
Standard Error of Measurement (SEM):

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

Minimal Detectable Change (MDC):

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%)
Minimally Clinically Important Difference (MCID):
Not Established
Cut-Off Scores:
Not Established
Normative Data:

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
BI, Barthel Index
FIM, Functional Independence Measure

Test-retest Reliability:

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
Interrater/Intrarater Reliability:

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

Internal Consistency:

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)
Criterion Validity (Predictive/Concurrent):

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)
Construct Validity (Convergent/Discriminant):
Stroke:
(Schuling et al, 1993; Tooth et al, 2003)
  • 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)
Content Validity:
Not Established
Face Validity:
Not Established
Floor/Ceiling Effects:

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%)
Traumatic Limb Injury:
(Chern et al, 2014, Traumatic Limb Injury, Chinese Version)
  • 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%)
Responsiveness:
Stroke:
(Schepers et al, 2006; Wade et al, 1985, Stroke)
  • 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
Considerations:

Frenchay Activities Index translations:

French (p26):
http://ift.tt/29GPVmo

Spanish (p288):
http://ift.tt/29GmchF

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Bibliography:

Chern, J., et al. (2014). Validation of a chinese version of the frenchay activities index in patients with traumatic limb injury. Journal of Occupational Rehabilitation, 24(3), 439-445. Find it on PubMed

Cup, E., Reimer, W., et al. (2003). "Reliability and validity of the Canadian Occupational Performance Measure in stroke patients." Clinical rehabilitation 17(4): 402-409. Find it on PubMed

Green, J., Forster, A., et al. (2001). "A test-retest reliability study of the Barthel Index, the Rivermead Mobility Index, the Nottingham Extended Activities of Daily Living Scale and the Frenchay Activities Index in stroke patients." Disability and Rehabilitation 23(15): 670-676. Find it on PubMed

Hedman, A., et. al. (2013) Patterns of functioning in older adults with mild cognitive impairment: A two-year study focusing on everyday technology use. Aging & Mental Health, 17(6), 679-688. Find it on PubMed

Holbrook, M. and Skilbeck, C. (1983). "An activities index for use with stroke patients." Age and Ageing 12(2): 166.

Hsieh, R., Lee, W. (2014). Short-term therapeutic effects of 890-nanometer light therapy for chronic low back pain: A double-blind randomized placebo-controlled study. Lasers in Medical Science, 29(2), 671-679.

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Kujanpää T., et. al. (2014) Prevalence of anxiety disorders among Finnish primary care high utilizers and validation of Finnish translation of GAD-7 and GAD-2 screening tools. Scand J Prim Health Care. 2014;32:78–83. Find it on PubMed

Lin, K. C., Chen, H. F., et al. (2012). "Multidimensional Rasch validation of the Frenchay Activities Index in stroke patients receiving rehabilitation." J Rehabil Med 44(1): 58-64. Find it on PubMed

Lu, W. S., Chen, C. C., et al. (2012). "Smallest real difference of 2 instrumental activities of daily living measures in patients with chronic stroke." Arch Phys Med Rehabil 93(6): 1097-1100. Find it on PubMed

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Miller, W. C., Deathe, A. B., et al. (2004). "Measurement properties of the Frenchay Activities Index among individuals with a lower limb amputation." Clinical Rehabilitation 18(4): 414-422. Find it on PubMed

Miller, W. C., Deathe, A. B., et al. (2001). "The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity amputation." Arch Phys Med Rehabil 82(9): 1238-1244. Find it on PubMed

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Piercy, M., Carter, J., et al. (2000). "Inter-rater reliability of the Frenchay Activities Index in patients with stroke and their carers." Clinical rehabilitation 14(4): 433.

Post, M. and Witte, L. (2003). "Good inter-rater reliability of the Frenchay Activities Index in stroke patients." Clinical rehabilitation 17(5): 548. Find it on PubMed

Sarker, S. J., Rudd, A. G., et al. (2012). "Comparison of 2 extended activities of daily living scales with the Barthel Index and predictors of their outcomes: cohort study within the South London Stroke Register (SLSR)." Stroke 43(5): 1362-1369. Find it on PubMed

Schepers, V. P. M., Ketelaar, M., et al. (2006). "Responsiveness of functional health status measures frequently used in stroke research." Disability and Rehabilitation 28(17): 1035-1040. Find it on PubMed

Schuling, J., De Haan, R., et al. (1993). "The Frenchay Activities Index. Assessment of functional status in stroke patients." Stroke 24(8): 1173. Find it on PubMed

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Wade, D., Legh-Smith, J., et al. (1985). "Social activities after stroke: measurement and natural history using the Frenchay Activities Index." Disability & Rehabilitation 7(4): 176-181. Find it on PubMed

Walters, S., Morrell, C., et al. (1999). "Measuring health-related quality of life in patients with venous leg ulcers." Quality of life Research 8(4): 327-336. Find it on PubMed

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Year published: 1983
Instrument in PDF Format: Yes


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