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Source publication
This study determined whether the Functional Independence Measure (FIM) and the Frenchay Activities Index (FAI) could be used together as a more comprehensive score to assess the activities of daily living (ADL) in stroke survivors. Subjects were recruited from stroke patients consecutively admitted to the inpatient neurology or rehabilitation depa...
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To establish the feasibility and effectiveness of a community-based exercise programme for ambulatory patients with stroke discharged from rehabilitation.
Eighteen participants were recruited 3-12 months after onset of first stroke. Using a time series experimental design, the group completed a baseline period of 4 weeks (A1), a group exercise prog...
In current clinical practice, old patients with stroke are less frequently admitted to neurorehabilitation units following acute care than younger patients based on an assumption that old age negatively impacts the benefit obtained from high-intensity neurorehabilitation. Our objective was to test this assumption empirically in a large sample of pa...
Citations
... This enables clinicians to set measurable treatment goals, to make appropriate discharge arrangements, or to anticipate the need for community support [3,5]. To measure disability, clinicians and researchers often use basic ADL measurements, such as the Barthel-Index, the extended Barthel Index, modified Ranking Scale (see for an overview Weimar et al. 2002, [6]) or the Functional Independent Measurement (FIM) [5,7,8]. Of all these measurements the FIM, is worldwide one of the most often used measurements. ...
... Although FIM has some drawbacks (e.g. ceiling and floor effects; focus on physical domains) and was not primary meant to be comprehensive, it is often used as a gold standard tool to measure ADL [5,7,8]. The International Classification of Functioning, Disability and Health (ICF) framework set by the World Health Organization (WHO) was developed to optimize a common language among clinicians [9] and has become a standard in neurorehabilitation. ...
... Based on this new classification, ICF core-sets were established for stroke [10,11]. This facilitated the linking of ICF domains with existing standardized measurements [3,8,12,13]. Recently, new measurements incorporating ICF domains were developed, in the form of self-reported questionnaires [12,14], or mono disciplinary observation tools for nurses [15], physiotherapists [16] and occupational therapists [17]. ...
Introduction
Une évaluation des capacités des patients qui ont subi un accident vasculaire cérébral (AVC) alors qu’ils vaquent à leurs activités quotidiennes est très importante afin de planifier une réadaptation ciblée. Des instruments suffisamment sensibles pour pouvoir démontrer les modifications des capacités d’un patient font défaut en pratique hospitalière quotidienne. C’est la raison pour laquelle un nouvel instrument (LIMOS), basé sur des observations multidisciplinaires des items de l’ICF a été développé.
Méthode
La fiabilité, la validité et la capacité de réponse de l’échelle LIMOS ont été évaluées sur un groupe de patients qui avaient subi un AVC. La convergence de validité a été comparée en mesurant la corrélation des scores globaux de l’échelle LIMOS et de la Mesure de l’Indépendance Fonctionnelle (MIF). La capacité de réponse, les effets plancher et plafond des sous-échelles motrices et cognitives ont été comparées avec les sous-échelles cognitives de la MIF et de l’index de Barthel.
Résultats
LIMOS présente une consistance intrinsèque élevée, ainsi qu’une bonne fiabilité de test-retest. Des éléments communs significatifs entre LIMOS et la MIF indiquent une bonne convergence de validité. Les sous-échelles LIMOS n’indiquent ni effets plancher, ni effet plafond. Les sous-échelles « LIMOS motricité » ainsi que « LIMOS cognition et communication » sont significativement corrélées avec une modification des sous-échelles motrices et cognitives de la MIF.
Conclusions
LIMOS est un instrument d’observation multidisciplinaire fiable, valable et qui possède une bonne capacité de réponse pour les patients qui ont subi un AVC. C’est un outil simple et bref à expliquer. Ce dernier point est important car chaque discipline évalue son propre sous-groupe au sein de l’échelle globale. La tendance actuelle à raccourcir la durée des séjours hospitaliers et l’efficience qui ne cesse de s’accroître en matière de traitement des AVC indiquent que les connaissances sur les activités de la vie quotidienne sont décisives si l’on souhaite les optimiser.
Signification
LIMOS est une nouvelle échelle d’observation basée sur l’ICF. Elle peut être employée quotidiennement par des équipes multidisciplinaires en milieu hospitalier.
... This enables clinicians to set measurable treatment goals, to make appropriate discharge arrangements, or to anticipate the need for community support [3,5]. To measure disability, clinicians and researchers often use basic ADL measurements, such as the Barthel-Index, the extended Barthel Index, modified Ranking Scale (see for an overview Weimar et al. 2002, [6]) or the Functional Independent Measurement (FIM) [5,7,8]. Of all these measurements the FIM, is worldwide one of the most often used measurements. ...
... Although FIM has some drawbacks (e.g. ceiling and floor effects; focus on physical domains) and was not primary meant to be comprehensive, it is often used as a gold standard tool to measure ADL [5,7,8]. ...
... Based on this new classification, ICF core-sets were established for stroke [10,11]. This facilitated the linking of ICF domains with existing standardized measurements [3,8,12,13]. Recently, new measurements incorporating ICF domains were developed, in the form of self-reported questionnaires [12,14], or mono disciplinary observation tools for nurses [15], physiotherapists [16] and occupational therapists [17]. ...
Valid and multidisciplinary assessment of a stroke patient's ability to perform activities of daily living is very important to define individual goals and to plan targeted rehabilitation. Until today, there is no observation scale that relies on International Classification of Functioning, Disability and Health (ICF). The aim of the present study was to develop and evaluate the reliability and validity of a new multidisciplinary observation scale for stroke patients, shortly called LIMOS, which is based on ICF.
In a first phase, LIMOS was defined, using a Delphi approach, by an expert panel and a pilot testing was conducted in a small group of stroke patients (n =10) to investigate feasibility and practicability. In a second phase, LIMOS was assessed for its reliability (internal consistency and test-retest reliability) and validity in a large cohort of stroke patients (n = 102). For convergent validity, the correlation between total scores of the LIMOS and the Functional Independence Measure (FIM) was assessed.
LIMOS consisted of seven ICF chapters incorporating 45 domains. A high internal consistency (=0.98) of LIMOS was found. Furthermore, good test-retest reliability at item and subscale level was found. Principal component analysis revealed that among the seven ICF chapters, four components could be found: (1) interpersonal activities, mobility and self-care, (2) communication, (3) knowledge and general tasks, and (4) domestic life. Significant associations were found between LIMOS and the FIM indicating good convergent validity.
The new LIMOS is a reliable and valid observation scale for stroke patients based on ICF, which can be used by a multidisciplinary team working in a neurorehabilitation setting.
... Although most of the studies using the FAI have been related to outcomes following stroke (112,(208)(209)(210)(211)(212)(213)(214)(215)(216)(217)(218)(219)(220)(221)(222)(223)(224)(225)(226), the index has also been used for other populations, including those with complex disabilities (227), lower limb amputation (228,229), acquired brain injury (230), multiple sclerosis (231), and caregivers (162). The scale has also been translated for and used to study rehabilitation outcomes in Japan (232), China (233), Denmark (224), and Spain (234, 235). ...
Background/aims
Factors that influence functional ability in older adults after rehabilitation are not well understood. The aim of this study was to investigate how older people function in their community after being discharged from inpatient rehabilitation.
Methods
A cross-sectional study was undertaken of community-dwelling older adults (n=86, 75 ± 6 years) discharged from rehabilitation in the previous 12 months. Basic functional independence was assessed using the Functional Independence Measure and complex functional independence was assessed using the Frenchay Activities Index. Multiple regression analyses were conducted to assess any association between predetermined factors and function.
Results
Functional Independence Measure scores and physical activity levels after being discharged accounted for 50% of the variance in basic function (R ² =0.50, F=40.75, P<0.001). Frenchay Activities Index scores, physical activity, age, sex and migrant status accounted for 68% of variance in complex function (R ² =0.68, F=29.75, P<0.001).
Conclusions
Clinicians are encouraged to implement strategies to improve function at discharge from rehabilitation and to promote physical activity among older people at risk of poor function following rehabilitation.
Activities of daily living are important indicators of the functional status and wellbeing of older persons. Data derived from life-style activities of the community at large are important for such diverse purposes as characterising the individual's ability for independent living, studying normal ageing, or investigating social factors in rehabilitation. Our objective was to determine patterns in the life-style activities of people aged 65 years and older who had no intellectual impairment.
The article is a cross-sectional study of a population-based sample. Eligible people were non-institutionalised and aged 65 years or older, resident in the province of Guadalajara, Spain, and without intellectual impairment as assessed by the 10-item Short Portable Mental Status Questionnaire. Questionnaires were administered by trained interviewers and included questions about the daily activities of the Adelaide Activities Profile (AAP), distributed among the four categories of domestic chores, household maintenance, service to others, and social activities. Each item was rated 0 = absent or 1 = present, and total scores ranged from 0 to 19.
The sample included 192 men and 196 women from rural areas and 172 men and 220 women from urban areas. In the category of domestic chores, mean ratings for women (4.56, 95% CI 4.30 to 4.84) were significantly higher (p <0.05) than for men (1.36, 95% CI 1.11 to 1.62) both in urban and rural areas, except in the oldest age group (> or =85 years). In the subscale of household maintenance, also except for group of > or =85 years, men rated significantly higher (3.31, 95% CI 3.11 to 3.53) than women (2.34, 95% CI 2.21 to 2.47), independent of the place of residence. Women scored significantly higher than men in activities associated with service to others. Men younger than 80 years from rural areas were significantly more involved in social activities than women. In urban areas both sexes scored similarly in social activities
The differences found among the AAP scales in relation to gender was a clear indication of the well established roles for men and women in our sociocultural context. The 19-item version of the AAP scale is a valuable survey instrument as an objective guide for studying activities related to life-style in community settings.
Human urban navigation depends on environmental cognition and the decision making to choose route. Impairment of these two components may result in way-finding problems, one of the most frequent symptoms in patients with AD. Chiu and her colleagues had studies getting lost behavior in AD patients and concluded that the getting lost behavior in such patients is in part accounted by their executive dysfunction. Pai and his colleagues, on the other hand, used experimentally designed tasks to test AD patients what they have called "the retrogenetic hypothesis of navigational ability". They have been focused on environmental cognition. Recently, they have begun to explore this issue by using electrophysiological tools and yielded some results.
