title: Reliability, validity, and sensitivity to change of the lower extremity functional scale in individuals affected by stroke.
abstract: OBJECTIVE
  To investigate reliability, validity, and sensitivity to change of the Lower Extremity Functional Scale (LEFS) in individuals affected by stroke. The secondary objective was to test the validity and sensitivity of a single-item linear analog scale (LAS) of function.
  
  
  METHODS
  Prospective cohort reliability and validation study.
  
  
  METHODS
  A single rehabilitation department in an academic medical center.
  
  
  METHODS
  Forty-three individuals receiving neurorehabilitation for lower extremity dysfunction after stroke were studied. Their ages ranged from 32 to 95 years, with a mean of 70 years; 77% were men.
  
  
  METHODS
  Test-retest reliability was assessed by calculating the classical intraclass correlation coefficient, and the Bland-Altman limits of agreement. Validity was assessed by calculating the Pearson correlation coefficient between the instruments. Sensitivity to change was assessed by comparing baseline scores with end of treatment scores. Measurements were taken at baseline, after 1-3 days, and at 4 and 8 weeks.
  
  
  METHODS
  The LEFS, Short-Form-36 Physical Function Scale, Berg Balance Scale, Six-Minute Walk Test, Five-Meter Walk Test, Timed Up-and-Go test, and the LAS of function were used.
  
  
  RESULTS
  The test-retest reliability of the LEFS was found to be excellent (ICC = 0.96). Correlated with the 6 other measures of function studied, the validity of the LEFS was found to be moderate to high (r = 0.40-0.71). Regarding the sensitivity to change, the mean LEFS scores from baseline to study end increased 1.2 SD and for LAS 1.1 SD.
  
  
  CONCLUSIONS
  LEFS exhibits good reliability, validity, and sensitivity to change in patients with lower extremity impairments secondary to stroke. Therefore, the LEFS can be a clinically efficient outcome measure in the rehabilitation of patients with subacute stroke. The LAS is shown to be a time-saving and reasonable option to track changes in a patient's functional status.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Clinic, Scottsdale, 13400 E. Shea Boulevard, Scottsdale, AZ 85259(∗). Electronic address: jverheijde@mayo.edu.
authors.forename: Joseph L
authors.initials: JL
authors.lastname: Verheijde
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Hospital, Phoenix, AZ(†).
authors.forename: Fred
authors.initials: F
authors.lastname: White
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Hospital, Phoenix, AZ(‡).
authors.forename: James
authors.initials: J
authors.lastname: Tompkins
authors.affiliation: Department of Physical Medicine and Rehabilitation, Mayo Hospital, Phoenix, AZ(§).
authors.forename: Peder
authors.initials: P
authors.lastname: Dahl
authors.affiliation: Section of Biostatistics, Mayo Clinic, Scottsdale, Scottsdale, AZ(¶).
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Hentz
authors.affiliation: Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ(‖).
authors.forename: Michael T
authors.initials: MT
authors.lastname: Lebec
authors.affiliation: Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff, AZ(∗∗).
authors.forename: Mark
authors.initials: M
authors.lastname: Cornwall
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D057566:Self Report; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications / Q000503:physiopathology*; D000071939:Stroke Rehabilitation