title: Activity Index - a complementary ADL scale to the Barthel Index in the acute stage in patients with severe stroke.
abstract: OBJECTIVE
  It was the aim of this study to compare the Barthel Index (BI) and the activities of daily living (ADL) component of the Activity Index [AI(ADL)] regarding floor and ceiling effects, responsiveness and the predictive value for survival during the first week until 3 months after stroke onset.
  
  
  METHODS
  Basic ADL were assessed in 75 patients with ischaemic stroke.
  
  
  RESULTS
  There was a strong concordance between BI and AI(ADL) scores at all time points (Kendall's taub = 0.7878, p < 0.0001 at baseline; Kendall's taub = 0.8901, p < 0.0001 at 1 week; Kendall's taub = 0.9027, p < 0.0001 at 3 months). BI had a significantly more pronounced floor effect at baseline and at 1 week compared with AI(ADL) in patients with severe stroke. Both scales had a substantial ceiling effect at 3 months. At 1 week, the baseline BI score was significantly higher in patients being alive as compared with those who had died, while their AI(ADL) score did not differ significantly. At 3 months, baseline BI and AI(ADL) scores were significantly higher in patients being alive as compared with those who had died. The predictive value of being alive at 1 week and 3 months did not differ between BI and AI(ADL).
  
  
  CONCLUSIONS
  AI(ADL) is recommended to be used in addition as a complement to BI in patients with severe stroke since the floor effect with BI in the acute stage is significantly more pronounced than with AI(ADL), thus hampering the responsiveness.
authors.affiliation: Institution of Clinical Neurosciences, Karolinska Institutet and the Stroke Research Unit, Department of Neurology, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: Louise
authors.initials: L
authors.lastname: Martinsson
authors.forename: Staffan
authors.initials: S
authors.lastname: Eksborg
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003913:Dextroamphetamine / Q000627:therapeutic use; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D020127:Recovery of Function; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy / Q000628:therapy; D000071939:Stroke Rehabilitation; D016019:Survival Analysis
chemical_list: D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine