Article

OBJECTIVE: 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. SETTING: 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 (rho) to examine
concurrent validity. RESULTS: 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
(rho = 0.8) and after treatment (rho = 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 (rho = 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 (rho = 0.6) and fair correlations with the Stroke Impact Scale total score
and Motor Activity Log (rho = 0.2-0.5). CONCLUSIONS: 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.

Langue : ANGLAIS