Comparison of postal version of the Frenchay Activities Index with interviewer-administered version for use in people with stroke

Abstract

Objective: To assess the agreement between postal and interviewer-administered versions of the Frenchay Activities Index (FAI) and to assess the criterion validity of the postal version, using interviewer administration as a gold standard.

Design: Comparison of responses to FAI administered by post and then by interview (median delay 10 days).

Subjects: Forty-eight Oxfordshire residents admitted to hospital with acute stroke between 1 August 1994 and 31 January 1995 and discharged alive within six months of their stroke.

Results: The limits of agreement of the total FAI score are from -5.4 to 7.2. The kappa statistic for each of the 15 individual items that make up the FAI ranged from 0.35 to 1. For nine items, agreement was moderate or fair, and for six items, agreement was good or very good. The mean difference between the overall scores was 0.9 (95% confidence interval: -0.1 to 1.9). The correlation between the overall scores was 0.94 (Spearman's rank correlation coefficient).

Conclusion: The postal version of the FAI is a satisfactory alternative to direct administration, but poor agreement in scores for individual patients emphasizes that the two approaches should not be used sequentially to monitor individual patients.

Get full access to this article

View all access options for this article.

References

Holbrook M. , Skilbeck CE An activities index for use with stroke patients. Age Ageing 1983; 12: 166-70.

Wade DT , Collin C. The Barthel ADL Index: a standard measure of physical disability? Int Disabil Studies 1988; 10: 64-67.

Wade DT , Legh-Smith J. , Langton-Hewer R. Social activities after stroke: measurement and natural history using the Frenchay Activities Index. Int Rehabil Med 1985; 7: 176-81.

Segal ME , Schall RR Determining functional/health status and its relation to disability in stroke survivors. Siroke 1994; 25: 2391-97.

Schuling J. , de Haan R. , Limburg M. , Groenier KH The Frenchay Activities Index: assessment of functional status in stroke patients . Stroke 1993; 24: 1173-77.

Bamford J. , Sandercock P. , Dennis M. et al. A prospective study of acute cerebrovascular disease in the community: the Oxfordshire Community Stroke Project 1981-86. 1. Methodology, demography and incident cases of first ever stroke. J Neurol Neurosurg Psychiatry 1988; 51: 1373-80.

Bland JM , Altman DG Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; i: 307-10.

Altman DG Practical statistics for medical research. London: Chapman and Hall, 1991: 404-408.

Yeo D. , Faleiro R. , Lincoln NB Barthel ADL Index: a comparison of administration methods. Clin Rehabil 1995; 9: 34-39.

10.

Chong D K-H. Measurement of instrumental activities of daily living in stroke. Stroke 1995; 26: 1119-22.

11.

de Haan R. , Aaronson N. , Limburg M. , Langton-Hewer R. , van Crevel H. Measuring quality of life in stroke. Stroke 1993; 24: 320-27.

12.

Wyller TB , Sveen U. , Bautz-Holter E. The Frenchay Activities Index in stroke patients: agreement between scores by patients and by relatives. Disabil Rehabil 1996; 18: 454-59.