Objective: To assess inter-rater reliability of the Frenchay Activities Index (FAI) when used by occupational therapists in stroke patients.
Design: Independent administration of the FAI by occupational therapists in 45 stroke outpatients.
Setting: Outpatient departments of two Dutch rehabilitation centres.
Statistics: Agreement between pairs of raters was assessed at item level using weighted Kappa and the percentage absolute agreement and for the total score using intra-class correlations (ICC), Bland–Altman plots and computation of the smallest real difference (SMR).
Results: ICC of the total score was good (0.90; 95% confidence interval (95% CI): 0.82–0.94). The Bland–Altman plot did not reveal relationships between agreement and height of scores. Reliability at item level was good (kappa >0.60) in 11 out of 15 items. The item ‘gainful work’ showed high agreement but a low kappa due to an extremely skewed score distribution. Reliability was insufficient in three items: ‘local shopping’, ‘social occasions’ and ‘actively pursuing hobby’. Clarification of scoring instructions of these items might further improve the inter-rater reliability of the FAI.
Conclusion: The FAI is a reliable instrument to measure outcomes of outpatient rehabilitation in patients with stroke.
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