Validation of the Frenchay activity index on stroke victims

Abstract

Purpose To evaluate the inter-rater reliability and predictive validity of the Frenchay Activities Index (FAI) in patients after stroke. Methods One hundred sixty-one patients were selected for consecutive application of the FAI and National Institutes of Health Stroke Scale (NIHSS). Spearman’s test was used for correlation between different scales. The FAI and NIHSS association was evaluated using ordinal logistic regression. Additionally, 36 patients underwent FAI rating on the same day by two independent evaluators. Results A negative correlation between the FAI and the NIHSS scores (p = 0.017 r = -0.22) was found. Adjusting all variables with possible association with the NIHSS, ordinal logistic regression showed that the FAI had a significant association with NIHSS scores (OR 0.93, 95% CI 0.87 to 0.99, p: 0.033). The inter-rater agreement was considered good, k = 0.66 (0.54 to 0.78), p < 0.001. Conclusions The FAI is a valid and useful method to assess instrumental activities before acute stroke in a Brazilian population.

The outcome measures for loss of functionality in the activities of daily living of adults after stroke: a systematic review

“…The most commonly used tools were: The Frenchay Activities Index (FAI), validated in Chinese, 43 Brazilian, 50 English, 54 and Dutch 55 ; the Activity Card Sort (ACS), validated in Chinese 27 and Israeli 38 ; the Daily Living Self-Efficacy Scale (DLSES), validated in Chinese 42 and Australian English 47 ; the Reintegration to Normal Living Index (RNLI), validated in Chinese 53 and Australian English 59 ; the Functional Independence Measure (FIM), validated in French-Canadian 26 and Persian. 51 Additionally, two further studies included the FIM instrument, one 49 in Japanese validating its use in combination with the Functional Assessment Measure (FAM) scale, the other study 46 validating only the motor subscale in the Scandinavian language.…”

“…Follow-up rate; statistical analyses Thirteen studies [25][26][27]29,30,32,33,[41][42][43]50,51,58 reported data on follow-up. Usually, an acceptable overall follow-up rate is considered to be 80% or more of participants whose exposures were measured at baseline.…”

“…In 6 studies, 27,38,40,42,54 this percentage was lower than 20%. Only in 13 [25][26][27]29,30,32,33,[41][42][43]50,51,58 studies were key potential confounding variables measured and adjusted for, such as by statistical adjustment for baseline differences; in other studies this process was not reported.…”

“…It has been used to assess ADLs three and six months before a stroke and consists of 15 items that measure complex activities in the categories of domestic activity, work/leisure, and outdoor activity. 50 The FAI score is based on the frequency with which activities are performed, ranging from 0 (inactive) to 45 (very active): 0-15 = inactive, 16-30 = moderately active, and 31-45 = very active. The cutoff of ≥ 18 has been used as a predictor of mild disability after stroke.…”

“…The cutoff of ≥ 18 has been used as a predictor of mild disability after stroke. 50 According to its developer, the FAI can be used to record premorbid levels of functioning, thus facilitating the negotiation of realistic rehabilitation goals, and to measure changes in the levels of functioning due to stroke. 55 It usually takes only a few minutes to complete and is very easy to administer.…”