Subscribe to RSS
![](/products/assets/desktop/img/oa-logo.png)
DOI: 10.1590/0004-282X20170014
Validation of the Frenchay activity index on stroke victims
Validação do índice de atividades de Frenchay em indivíduos após AVC![](https://www.thieme-connect.de/media/10.1055-s-00054595/201703/lookinside/thumbnails/10-1590-0004-282x20170014_20170014-1.jpg)
ABSTRACT
Purpose
To evaluate the inter-rater reliability and predictive validity of the Frenchay Activities Index (FAI) in patients after stroke.
Methods
One hundred sixty-one patients were selected for consecutive application of the FAI and National Institutes of Health Stroke Scale (NIHSS). Spearman’s test was used for correlation between different scales. The FAI and NIHSS association was evaluated using ordinal logistic regression. Additionally, 36 patients underwent FAI rating on the same day by two independent evaluators.
Results
A negative correlation between the FAI and the NIHSS scores (p = 0.017 r = -0.22) was found. Adjusting all variables with possible association with the NIHSS, ordinal logistic regression showed that the FAI had a significant association with NIHSS scores (OR 0.93, 95% CI 0.87 to 0.99, p: 0.033). The inter-rater agreement was considered good, k = 0.66 (0.54 to 0.78), p < 0.001.
Conclusions
The FAI is a valid and useful method to assess instrumental activities before acute stroke in a Brazilian population.
RESUMO
Objetivo
Avaliar a confiabilidade inter-examinador e a validade preditiva do Índice de Atividades de Frenchay (FAI) em pacientes após acidente vascular cerebral.
Métodos
161 pacientes foram selecionados para aplicação consecutiva da FAI e NIH Stroke Scale (NIHSS). O teste de Spearman foi utilizado para correlação entre as diferentes escalas. A associação FAI e NIHSS foi avaliada por meio de regressão logística ordinal. Adicionalmente, 36 pacientes foram submetidos à aplicação do FAI por dois avaliadores independentes, no mesmo dia.
Resultados
Foi encontrada uma correlação negativa entre o FAI e o NIHSS (r = -0,22; p = 0,017). Ajustando todas as variáveis com possível associação com NIHSS, a regressão logística ordinal demonstrou que o FAI tem associação significativa com o NIHSS (OR 0,93, 95% CI 0,87-0,99, p: 0,033). A concordância entre avaliadores foi considerada boa, k = 0,66 (0,54-0,78), p < 0,001.
Conclusões
FAI é um método válido e útil para avaliar atividades instrumentais antes de AVC agudo em uma população brasileira.
Study conducted at the Hospital Geral Roberto Santos, Salvador, Brazil.
Publication History
Received: 25 November 2014
Accepted: 21 November 2016
Article published online:
05 September 2023
© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
Thieme Revinter Publicações Ltda.
Rua do Matoso 170, Rio de Janeiro, RJ, CEP 20270-135, Brazil
-
References
- 1 Adamson J, Beswick A, Ebrahim S. Is stroke the most common cause of disability? J Stroke Cerebrovasc Dis. 2004;13(4):171-7. https://doi.org/10.1016/j.jstrokecerebrovasdis.2004.06.003
- 2 Ferri CP, Schoenborn C, Kalra L, Acosta D, Guerra M, Huang Y et al. Prevalence of stroke and related burden among older people living in Latin America, India and China. J Neurol Neurosurg Psychiatry. 2011;82(10):1074-82. https://doi.org/10.1136/jnnp.2010.234153
- 3 Thijs VN, Lansberg MG, Beaulieu C, Marks MP, Moseley ME, Albers GW. Is early ischemic lesion volume on diffusion-weighted imaging an independent predictor of stroke outcome? A multivariable analysis. Stroke. 2000;31(11):2597-602. https://doi.org/10.1161/01.STR.31.11.2597
- 4 Weimar C, Ziegler A, König IR, Diener HC. Predicting functional outcome and survival after acute ischemic stroke. J Neurol. 2002;249(7):888-95. https://doi.org/10.1007/s00415-002-0755-8
- 5 Endres M, Gertz K, Lindauer U, Katchanov J, Schultze J, Schröck H et al. Mechanisms of stroke protection by physical activity. Ann Neurol. 2003;54(5):582-90. https://doi.org/10.1002/ana.10722
- 6 Bragoni M, Caltagirone C, Troisi E, Matteis M, Vernieri F, Silvestrini M. Correlation of cerebral hemodynamic changes during mental activity and recovery after stroke. Neurology. 2000;55(1):35-40. https://doi.org/10.1212/WNL.55.1.35
- 7 Bode RK, Rychlik K, Heinemann AW, Lovell L, Modla L. Reconceptualizing poststroke activity level using the Frenchay Activities Index. Top Stroke Rehabil. 2003;9(4):82-91. https://doi.org/10.1310/RCWL-75JJ-JREW-FVQT
- 8 Schuling J, de Haan R, Limburg M, Groenier KH. The Frenchay Activities Index. Assessment of functional status in stroke patients. Stroke. 1993;24(8):1173-7. https://doi.org/10.1161/01.STR.24.8.1173
- 9 Wade DT, Legh-Smith J, Langton Hewer R. Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehabil Med. 1985;7(4):176-81. https://doi.org/10.3109/03790798509165991
- 10 Kulzer AM. Associação entre atividades físicas, cognitivas e sociais e o grau de recuperação funcional após acidente vascular cerebral [dissertation]. Universidade Federal do Rio Grande do Sul, Porto Alegre, 2006.
- 11 World Health Organization. WHO STEPS Stroke manual: the WHO STEP wise approach to stroke surveillance/ Non communicable diseases and mental health. Geneva: World Health Organization; 2005.
- 12 Anderson CS, Jamrozik KD, Broadhurst RJ, Stewart-Wynne EG. Predicting survival for 1 year among different subtypes of stroke. Results from the Perth Community Stroke Study. Stroke. 1994;25(10):1935-44. https://doi.org/10.1161/01.STR.25.10.1935
- 13 Külzer AM, Scolari CC, Gus M. Relationship between usual physical, cognitive and social activities and functional recovery at hospital discharge after acute stroke. J Rehabil Med. 2008;40(3):195-9. https://doi.org/10.2340/16501977-0149
- 14 Brott T, Adams HP Jr, Olinger CP, Marler JR, Barsan WG, Biller J et al. Measurements of acute cerebral infarction: a clinical examination scale. Stroke. 1989;20(7):864-70. https://doi.org/10.1161/01.STR.20.7.864
- 15 Cincura C, Pontes-Neto OM, Neville IS, Mendes HF, Menezes DF, Mariano DC et al. Validation of the National Institutes of Health Stroke Scale, modified Rankin Scale and Barthel Index in Brazil: the role of cultural adaptation and structured interviewing. Cerebrovasc Dis. 2009;27(2):119-22. https://doi.org/10.1159/000177918
- 16 Brennan P, Silman A. Statistical methods for assessing observer variability in clinical measures. BMJ. 1992;304(6840):1491-4. https://doi.org/10.1136/bmj.304.6840.1491
- 17 Post MW, Witte LP. Good inter-rater reliability of the Frenchay: activities Index in stroke patients. Clin Rehabil. 2003;17(5):548-52. https://doi.org/10.1191/0269215503cr648oa
- 18 Green J, Forster A, Young J. A test-retest reliability study of the Barthel Index, the Rivermead Mobility Index, the Nottingham Extended Activities of Daily Living Scale and the Frenchay Activities Index in stroke patients. Disabil Rehabil. 2001;23(15):670-6. https://doi.org/10.1080/09638280110045382 PMID:11720117
- 19 Piercy M, Carter J, Mant J, Wade DT. Inter-rater reliability of the Frenchay Activities Index in patients with stroke and their carers. Clin Rehabilit. 2000;14:433-40. https://doi.org/10 10.1191/0269215500cr327oa.
- 20 Imam B, Miller WC. Reliability and validity of scores of a Chinese version of the Frenchay Activities Index. Arch Phys Med Rehabil. 2012;93(3):520-6. https://doi.org/10.1016/j.apmr.2011.07.197
- 21 Krarup LH, Truelsen T, Pedersen A, Lerke H, Lindahl M, Hansen L et al. Level of physical activity in the week preceding an ischemic stroke. Cerebrovasc Dis. 2007;24(2-3):296-300. https://doi.org/10.1159/000105683
- 22 Wu CY, Chuang LL, Lin KC, Horng YS. Responsiveness and validity of two outcome measures of instrumental activities of daily living in stroke survivors receiving rehabilitative therapies. Clin Rehabil. 2011;25(2):175-83. https://doi.org/10.1177/0269215510385482
- 23 Hsueh IP, Huang SL, Chen MH, Jush SD, Hsieh CL. Evaluation of stroke patients with the extended activities of daily living scale in Taiwan. Disabil Rehabil. 2000;22(11):495-500. https://doi.org/10.1080/096382800413989
- 24 Martins T, Ribeiro J, Garret C. Estudo de adaptação e validação do Frenchay Activities Index FAI numa amostra de doentes com baixa escolaridade afetados por acidente vascular cerebral. Arq Med. 2003;17:88-91.
- 25 Lin KC, Chen HF, Wu CY. Multidimensional rash validation of the Frenchay Activities Index in stroke patients receiving rehabilitation. J Rehabil Med. 2012;44(1):58-64. https://doi.org/10.2340/16501977-0911
- 26 Ytterberg C, Johansson S, Andersson M, Widén Holmqvist L, von Koch L. Variations in functioning and disability in multiple sclerosis: a two-year prospective study. J Neurol. 2008;255(7):967-73. https://doi.org/10.1007/s00415-008-0767-0
- 27 Chang- Wan Han, Yuki Yajima et al. Construct validity of the Frenchay Activities Index for community-dwelling elderly in Japan. Tohoku J Exp Med. 2006;201(2):99-107.
- 28 Turnbull JC, Kersten P, Habib M, McLellan L, Mullee MA, George S. Validation of the Frenchay Activities Index in a general population aged 16 years and older. Arch Phys Med Rehabil. 2000;81(8):1034-8. https://doi.org/10.1053/apmr.2000.7162
- 29 Dobkin BH. Clinical practice. Rehabilitation after stroke. N Engl J Med. 2005;352(16):1677-84. https://doi.org/10.1056/NEJMcp043511