Issues for selection of outcome measures in stroke rehabilitation: ICF activity.
OBJECTIVE
To evaluate the psychometric and administrative properties of outcome measures in the WHO International Classification of Functioning, Disability and Health (ICF) Activity category used in stroke rehabilitation research and reported in the published literature.


METHODS
Critical review and synthesis of measurement properties for nine commonly reported instruments in the stroke rehabilitation literature. Each instrument was rated using the eight evaluation criteria proposed by the UK Health Technology Assessment (HTA) programme. The instruments were also assessed for the rigour with which their reliability, validity and responsiveness were reported in the published literature.


RESULTS
The reporting of specific measurement qualities for outcome instruments was relatively consistent across measures located within the same general ICF category. There was evidence to suggest that the measures were responsive to change as well as being valid and reliable tools. The best available instruments were associated with the assessment of activities of daily living, balance (static and dynamic), functional independence, and functional mobility.


CONCLUSIONS
Given the diversity that exists among available measures, the reader is encouraged to examine carefully the nature and scope of outcome measurement used in reporting the strength of evidence for improved functional activity in stroke rehabilitation. However, there appears to be good consensus regarding the most important indicators of successful rehabilitation outcome, especially in the case of functional mobility.
Salter
K
K
Department of Physical Medicine and Rehabilitation, St. Joseph's Health Care London, Ontario, Canada. Katherine.Salter@sjhc.london.on.ca
Jutai
J W
JW
Teasell
R
R
Foley
N C
NC
Bitensky
J
J
Bayley
M
M
D000203:Activities of Daily Living; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000401:mortality / Q000534:rehabilitation*; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005069:Evaluation Studies as Topic; D005260:Female; D006302:Health Services Research; D006801:Humans; D008297:Male; D009864:Ontario; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D011594:Psychometrics; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D014944:World Health Organization