An extended activities of daily living scale for stroke patients

Abstract

A ranked assessment of daily living (ADL) scale has been developed to assess activities which may be important to stroke patients who have been discharged home. A questionnaire incorporating 22 ADL activities in four sections was sent by post to 80 consecutively registered stroke patients. Gutmann scaling was carried out on the returned questionnaires, producing acceptable coefficients of reproducibility and scalability. The revised questionnaire was then sent to 20 stroke patients. The same patients were sent an identical questionnaire two weeks later. The overall level of agreement between the two assessments was satisfactory. The extended ADL scale could therefore be used as a postal questionnaire to assist in the follow-up of patients discharged home after a stroke. Due to the scaling properties of the assessment, patient's progress can be monitored and patients can also be compared on the basis of their scale score.

References

Sivenius J. , Pyorala K. , Heinonen OP , Salonen JT , Riekkinen P. The significance of intensity of rehabilitation of stroke - a controlled trial . Stroke 1985; 16: 928-31.

Andrews K. , Brocklehurst JC , Richards B. , Laycock PJ The influence of age on the clinical presentation and outcome of stroke . Int Rehabil Med 1984; 6: 49-53.

De Jong G. , Branch LG Predicting the stroke patient's ability to live independently. Stroke 1982; 13: 648-55.

Feigenson JS , McCarthy ML , Meese PD et al. Stroke rehabilitation: Factors predicting outcome and length of stay - an overview. New York State J Med 1977; August: 1426-30.

Stevens RS , Ambler NR , Warren MD A randomised controlled trial of a stroke rehabilitation ward. Age Ageing 1984; 13: 65-75.

Wade DT , Legh-Smith J. , Langton Hewer R. Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehab Med 1985 ; 7: 176-81.

Whiting S. , Lincoln NB An ADL assessment for stroke patients. Br J Occ Ther 1980; 2: 44-46.

Ebrahim S. , Nouri F. , Barer D.

Measuring disability after a stroke. J Epid Comm

Health 1985; 39: 86-89 .

Mahoney FI , Barthel DW

Functional evaluation: the Barthel Index. Maryland State

Med J 1965; 14: 61-65.

10.

Sheikh K. , Smith DS , Meade TW et al. Repeatability and validity of a modified ADL index in studies of chronic disability. Inter J Rehabil Med 1979; 1: 51-58.

11.

Cohen J. A coefficent of agreement for nominal scales. Educational Psychological Measurement 1960; 20: 37-46.

12.

Fleiss JL The measurement of inter-rater agreement. In: Statistical methods for rates and proportions. New York: John Wiley and Sons, 1981.

13.

Lincoln NB , Blackburn M. , Ellis S. , Jackson J. , Edmans JE , Nouri FM , Walker M. , Haworth H. An investigation of factors affecting progress of patients on a stroke unit . (In preparation).