van Bennekom C A, Jelles F, Lankhorst G J, Bouter L M
Department of Rehabilitation Medicine, Free University Hospital, Amsterdam, The Netherlands.
Arch Phys Med Rehabil. 1995 Jun;76(6):501-7. doi: 10.1016/s0003-9993(95)80502-8.
This study evaluates the criterion, content, and construct validity of the Rehabilitation Activities Profile (RAP) in patients with stroke. This instrument is constructed for screening, monitoring, and prognosis purposes to assist clinical rehabilitation. It consists of 21 activities, covering the domains communication, mobility, personal care, occupation, and relationships. Disabilities and perceived problems are assessed in parallel on two four-point severity scales. The disability sum scores of the first four RAP domains were used in the analyses presented in this article.
An inception cohort of stroke patients was studied during 26 weeks. Patients that were still hospitalized on the 14th day after stroke were included. The functional assessments took place 2, 3, 4, 8, 12, and 26 weeks after stroke.
The patients were visited at the hospital, at home, nursing home, or rehabilitation center.
125 patients were included in the study. After 26 weeks, 105 patients were still alive; 18 patients had died, and 2 patients were lost to follow-up.
The RAP, Barthel Index (BI) and Frenchay Activities Index (FAI).
The domain "mobility+personal care" correlated highly with the BI score (r: 0.87 to 0.90). The domain "occupation" correlated with the FAI score before the stroke and 26 weeks after stroke (r: 0.72, 0.73, respectively). The disability sum score of the domain "mobility+personal care" allowed a prediction of the living arrangement 26 weeks after stroke (receiver operator characteristic area surface: 0.90). The same domain showed significant differences (p < 0.05) in the 8-week disability sum score for most living arrangements. Exceptions were rehabilitation center versus intermediate care in a nursing home (p = 0.23) and acute care hospital versus chronic care in a nursing home (p = 0.45). Hypotheses on subgroup differences in mean scores in the domains "communication" and "mobility+personal care" could be confirmed (the discerned subgroups were: gender, having a partner, motor deficit of upper or lower extremity, urinary incontinence, higher cortical deficits, conjugate deviation of the eye, coma, hemianopsia).
The disability sum scores of the RAP can be used as discriminative, evaluative, and predictive indexes.
本研究评估了中风患者康复活动概况（RAP）的标准效度、内容效度和结构效度。该工具用于筛查、监测和预后评估，以辅助临床康复。它包含21项活动，涵盖沟通、移动性、个人护理、职业和人际关系等领域。在两个四点严重程度量表上并行评估残疾情况和感知到的问题。本文分析中使用了RAP前四个领域的残疾总分。
对一组中风患者起始队列进行了为期26周的研究。纳入了中风后第14天仍住院的患者。在中风后2、3、4、8、12和26周进行功能评估。
在医院、家中、养老院或康复中心对患者进行访视。
125例患者纳入研究。26周后，105例患者仍存活；18例患者死亡，2例患者失访。
RAP、Barthel指数（BI）和Frenchay活动指数（FAI）。
“移动性+个人护理”领域与BI评分高度相关（r：0.87至0.90）。“职业”领域与中风前和中风后26周的FAI评分相关（r分别为0.72、0.73）。“移动性+个人护理”领域的残疾总分可预测中风后26周的生活安排（受试者操作特征曲线下面积：0.90）。同一领域在大多数生活安排的8周残疾总分上存在显著差异（p<0.05）。例外情况是康复中心与养老院的中级护理（p = 0.23）以及急性护理医院与养老院的慢性护理（p = 0.45）。关于“沟通”和“移动性+个人护理”领域平均得分亚组差异的假设得到了证实（区分的亚组为：性别、有伴侣、上肢或下肢运动障碍、尿失禁, 高级皮质功能缺损、眼球共轭偏斜、昏迷、偏盲）。
RAP的残疾总分可作为鉴别、评估和预测指标。
