Responsiveness of functional health status measures frequently used in stroke research.
OBJECTIVE
To compare the responsiveness of several functional health status measures frequently used in stroke research, namely the Barthel Index (BI), Functional Independence Measure (FIM), Frenchay Activities Index (FAI) and Stroke-Adapted Sickness Impact Profile 30 (SA-SIP 30).


METHODS
Patients with a first-ever supratentorial stroke admitted for inpatient rehabilitation were included. Complete datasets for 163 patients were available for analysis. Floor/ceiling effects and responsiveness, quantified by effect sizes, were studied for the periods between rehabilitation admission and six months post stroke (subacute phase) and between six and 12 months post stroke (chronic phase).


RESULTS
Effect sizes in the subacute phase were similar and were classified as large for the BI, FIM total and FIM motor score. The FIM cognitive score showed a considerable ceiling effect and had the smallest effect size in the subacute phase. In the chronic phase, the FAI and SA-SIP 30 detected the most changes and had moderate effect sizes.


CONCLUSIONS
BI, FIM total and FIM motor score, FAI and SA-SIP 30 were responsive measures. We recommend the use of the BI in the subacute phase and the use of the FAI and SA-SIP 30 in the chronic phase, especially for the stroke rehabilitation population.
Schepers
V P M
VP
Center of Excellence for Rehabilitation Medicine Utrecht, Rehabilitation Center De Hoogstraat and Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht. V.Schepers@dehoogstraat.nl
Ketelaar
M
M
Visser-Meily
J M A
JM
Dekker
J
J
Lindeman
E
E
D000203:Activities of Daily Living; D035843:Biomedical Research; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D000071939:Stroke Rehabilitation