Department of Occupational Therapy and Graduate Institute of Clinical Behavioral Science, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
Clin Rehabil. 2011 Feb;25(2):175-83. doi: 10.1177/0269215510385482. Epub 2010 Nov 8.
To comprehensively investigate and compare the responsiveness and validity of two instrumental activities of daily living (ADL) measures: a modified version of the Nottingham Extended ADL Scale and the Frenchay Activities Index, after stroke rehabilitation.
Rehabilitation clinics.
Seventy stroke patients received a three-week intervention (mean (SD) age, 55.5 (12.1) years; 46 (65.7%) men; mean (SD) time post stroke, 19.9 (12.5) months).
Four outcome measures (modified Nottingham Extended ADL Scale, Frenchay Activities Index, Stroke Impact Scale and Motor Activity Log) were administered before and after treatment. We used the standardized response mean (SRM) to examine responsiveness and the Spearman correlation coefficient (ρ) to examine concurrent validity.
Responsiveness was significantly larger for the modified Nottingham Extended ADL Scale (SRM = 0.9) compared with the Frenchay Activities Index (SRM = 0.5). The correlations between the modified Nottingham Extended ADL Scale and Frenchay Activities Index were good to excellent before (ρ = 0.8) and after treatment (ρ = 0.8). The modified Nottingham Extended ADL Scale and Frenchay Activities Index showed fair correlations with the Stroke Impact Scale ADL/Instrumental ADL domain, Stroke Impact Scale total score and Motor Activity Log before treatment (ρ = 0.3-0.4). After treatment, the modified Nottingham Extended ADL Scale and Frenchay Activities Index demonstrated moderate to good correlations with the Stroke Impact Scale ADL/Instrumental ADL domain (ρ = 0.6) and fair correlations with the Stroke Impact Scale total score and Motor Activity Log (ρ = 0.2-0.5).
The modified Nottingham Extended ADL Scale and Frenchay Activities Index are both valid outcome measures but the modified Nottingham Extended ADL Scale is more responsive than the Frenchay Activities Index. While simultaneously considering the properties of responsiveness and validity, the modified Nottingham Extended ADL Scale may be a relatively sound measure of instrumental ADL function in stroke patients receiving rehabilitation.
全面调查和比较两种工具性日常生活活动（ADL）测量的反应性和有效性：经过卒中康复后的改良诺丁汉扩展 ADL 量表和 Frenchay 活动指数。
康复诊所。
70 名卒中患者接受了为期 3 周的干预（平均（SD）年龄，55.5（12.1）岁；46（65.7%）名男性；卒中后平均（SD）时间，19.9（12.5）个月）。
在治疗前后进行了四项结果测量（改良诺丁汉扩展 ADL 量表、Frenchay 活动指数、卒中影响量表和运动活动日志）。我们使用标准化反应均值（SRM）来检查反应性，使用斯皮尔曼相关系数（ρ）来检查同时效度。
改良诺丁汉扩展 ADL 量表的反应性明显大于 Frenchay 活动指数（SRM = 0.9 比 SRM = 0.5）。改良诺丁汉扩展 ADL 量表和 Frenchay 活动指数在治疗前后均具有良好到极好的相关性（ρ=0.8）。在治疗前，改良诺丁汉扩展 ADL 量表和 Frenchay 活动指数与卒中影响量表 ADL/工具性 ADL 域、卒中影响量表总分和运动活动日志呈中等相关（ρ=0.3-0.4）。治疗后，改良诺丁汉扩展 ADL 量表和 Frenchay 活动指数与卒中影响量表 ADL/工具性 ADL 域呈中等到高度相关（ρ=0.6），与卒中影响量表总分和运动活动日志呈中等相关（ρ=0.2-0.5）。
改良诺丁汉扩展 ADL 量表和 Frenchay 活动指数均为有效的结局测量，但改良诺丁汉扩展 ADL 量表的反应性强于 Frenchay 活动指数。在同时考虑反应性和有效性的特性时，改良诺丁汉扩展 ADL 量表可能是接受康复治疗的卒中患者工具性 ADL 功能的相对可靠测量。
