Measuring functional recovery in stroke patients: the responsiveness of ACTIVLIM-Stroke

Abstract

Background and purpose To determine the efficacy of the ACTIVLIM-Stroke questionnaire in detecting changes in functional status of stroke patients. Method Sixty-eight Benin and Belgian stroke patients participated in this 2-month longitudinal study, involving baseline and follow-up assessments. Outcome measures combined ACTIVLIM-Stroke questionnaire, Barthel Index (BI), 6-minute-walk test (6MWT) and modified Rankin scale (MRS). Responsiveness of ACTIVLIM-Stroke was investigated through different methodological approaches and compared with BI, 6MWT and MRS. Statistical analyses were performed using the paired t tests, effect size (ES) and correlation tests. Results ACTIVLIM-Stroke detected changes in the whole sample ( p<0.001, ES=0.78) and even in a subgroup of patients ( p<0.001, ES=0.29) that were classified as stable according to the MRS. Moreover, ACTIVLIM-Stroke permitted the classification of patients into more discriminative groups, including those showing an important improvement ( p<0.001, ES=1.87), a slight but non-clinically meaningful improvement ( p<0.001, ES=0.38), and no improvement ( p=0.1, ES=0.11), demonstrating its high sensitivity to change. Furthermore, there were concordant relationships between ACTIVLIM-Stroke change and any observed changes in BI, 6MWT and MRS scores (r≥0.50, p<0.001), confirming the external responsiveness of ACTVLIM-Stroke. Conclusions ACTIVLIM-Stroke showed good responsiveness and can detect accurately clinical changes in the functional status of stroke patients. The BI and the 6MWT were also responsive and may provide complementary information while investigating change in functional status. However, in addition to being highly sensitive to change, ACTIVLIM-Stroke presents significant methodological advantages for quantifying functional changes in stroke patients.

Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (HABIT-ILE) in adults with chronic stroke: protocol of a randomised controlled trial

“…It ranges from −6 to +6 logits, with higher scores indicating better performance. The ACTIVLIM-Stroke questionnaire has shown excellent test-retest reliability, good responsiveness and high sensitivity to change 48 49…”