Article

Tools used to measure poststroke functional status must include basic
and instrumental activities of daily living and reflect the patient's and the
clinician's perspective of the disease and its effect on daily living
performance. The authors combined the Functional Independence Measure
(FIM) and the Nottingham Extended Activities of Daily Living (NEADL) to create a
scale providing a comprehensive evaluation of ADLs functional status in patients
with stroke. METHODS: The study participants were 188 patients completing the FIM
and the NEADL. The psychometric properties of the combined measure were examined
with Rasch analysis. RESULTS: A 3-point scale and a dichotomous scale were
suggested for use in the FIM and the NEADL, respectively. The combined 40 items
worked consistently to reflect a single construct, and "bladder management" and
"bowel management" were highly related. After "bowel management" was removed from
the combined scale, all but 3 items fit the model's expectations, and the 39-item
scale showed reasonable item difficulty hierarchy, with high reliability. The 3
misfit items were removed, and no differences in unidimensionality, differential
item functioning, and reliability were found between the 36-item and 39-item
scales. CONCLUSIONS: The combined measure of the FIM and the NEADL provides a
comprehensive picture of ADLs. It extends the utility of the FIM and the NEADL
and is recommended for use to measure the independence of patients after
discharge home.

Langue : ANGLAIS