COMPREHENSIVE ASSESSMENT OF ACTIVITIES OF DAILY LIVING IN STROKE - THE COPENHAGEN STROKE STUDY

Objective: To assess activities of daily living (ADL) in stroke in a c omprehensive way. The BartheI Index (BI) is widely used in stroke rese arch, but is Limited because it measures basic ADL functions only. Thi s study sought to determine whether the Frenchay Activities Index (FAI ) is a good choice for supplementary assessment of higher order ADL fu nctions. Design: Prospective and consecutive. Setting: Follow-up inves tigation 6 months after stroke of patients who were admitted to, and c ompleted rehabilitation at, a stroke unit. Patients: 437 patients with strokes. Main Outcome Measures: Factor analysis of the BI, FAT, and t he Scandinavian Neurological Stroke Scale (SSS); distribution characte ristics of a comprehensive, combined ADL scale. Results: Five factors were found. One factor comprised all items from the BI and all the mot or items from the SSS, but no items from the FAI. The FAI loaded on th ree other factors. Finally, orientation and speech from the SSS loaded on a separate factor. A combined score consisting of the BI total sco re and a simple transformation of the FAI total score had a much impro ved distribution without strong ceiling or floor effects. Conclusions: The FAI supplements the BI with minimal overlap in content. A combine d total score has a distribution that makes it very usable for researc h in stroke outcome and stroke rehabilitation effect. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.