An initial investigation of the reliability of the Rivermead Extended ADL index in patients presenting with neurological impairment

The objective of this study was to establish the reliability and sensitivit y of both postal and interviewer-administrated versions of the Rivermead Ex tended Activities of Daily Living (READL) index, which assesses sis domesti c activities and six community activities. Sixty patients with stable neuro logical impairment were recruited. In one group (n = 40), every patient was assessed face-to-face using the READL, the Barthel index (BI) and the shor t orientation memory and concentration test (SOMC), One week later, the REA DL was repeated by the same person, in the same place. In the second group (n = 20), all the patients were first sent a postal form of the READL and w ere then seen face-to-face for assessment as in group 1, To be included pat ients had to score at least 18/28 points on the SOMC, Scores were compared using scatterplots, Bland and Altman plots and correlation coefficients, an d difference scores were calculated. Sensitivity was established comparing groups of patients expected to differ in their activities. Repeated assessm ent score, both fare-to-face and by post, showed significant correlation (P earson coefficient = 0.97 and 0.88, respectively), Most scores were within four points of each other, with no systematic bias, although patients tende d to rate themselves more independent. Both methods were able to detect dif ferences in the level of activities as predicted between more and less depe ndent groups (t-test: p < 0.00001 and p = 0.00087). The READL index appears to be a reliable and sensitive measure, with some evidence for validity, b ut further research is needed.