Marcel W M Post1, Luc P de Witte. 1. IRv, Institute for Rehabilitation Research, Hoensbroek, The Netherlands. m.post@irv.nl
Abstract
OBJECTIVE: To assess inter-rater reliability of the Frenchay Activities Index (FAI) when used by occupational therapists in stroke patients. DESIGN: Independent administration of the FAI by occupational therapists in 45 stroke outpatients. SETTING: Outpatient departments of two Dutch rehabilitation centres. STATISTICS: Agreement between pairs of raters was assessed at item level using weighted Kappa and the percentage absolute agreement and for the total score using intra-class correlations (ICC), Bland-Altman plots and computation of the smallest real difference (SMR). RESULTS: ICC of the total score was good (0.90; 95% confidence interval (95% CI): 0.82-0.94). The Bland-Altman plot did not reveal relationships between agreement and height of scores. Reliability at item level was good (kappa >0.60) in 11 out of 15 items. The item 'gainful work' showed high agreement but a low kappa due to an extremely skewed score distribution. Reliability was insufficient in three items: 'local shopping', 'social occasions' and 'actively pursuing hobby'. Clarification of scoring instructions of these items might further improve the inter-rater reliability of the FAI. CONCLUSION: The FAI is a reliable instrument to measure outcomes of outpatient rehabilitation in patients with stroke.
OBJECTIVE: To assess inter-rater reliability of the Frenchay Activities Index (FAI) when used by occupational therapists in strokepatients. DESIGN: Independent administration of the FAI by occupational therapists in 45 stroke outpatients. SETTING:Outpatient departments of two Dutch rehabilitation centres. STATISTICS: Agreement between pairs of raters was assessed at item level using weighted Kappa and the percentage absolute agreement and for the total score using intra-class correlations (ICC), Bland-Altman plots and computation of the smallest real difference (SMR). RESULTS: ICC of the total score was good (0.90; 95% confidence interval (95% CI): 0.82-0.94). The Bland-Altman plot did not reveal relationships between agreement and height of scores. Reliability at item level was good (kappa >0.60) in 11 out of 15 items. The item 'gainful work' showed high agreement but a low kappa due to an extremely skewed score distribution. Reliability was insufficient in three items: 'local shopping', 'social occasions' and 'actively pursuing hobby'. Clarification of scoring instructions of these items might further improve the inter-rater reliability of the FAI. CONCLUSION: The FAI is a reliable instrument to measure outcomes of outpatient rehabilitation in patients with stroke.
Authors: Monica Spruit-van Eijk; Bianca I Buijck; Sytse U Zuidema; Frans L M Voncken; Alexander C H Geurts; Raymond T C M Koopmans Journal: BMC Geriatr Date: 2010-03-27 Impact factor: 3.921
Authors: Ryanne J M Lemmens; Annick A A Timmermans; Yvonne J M Janssen-Potten; Rob J E M Smeets; Henk A M Seelen Journal: BMC Neurol Date: 2012-04-12 Impact factor: 2.474