Activities Of Daily Living Assessment Research Articles

Functional status after critical illness: agreement between patient and proxy assessments.

assessment of baseline functional status of older patients during and after intensive care unit (ICU) admission is often hampered by challenges related to the critical illness such as cognitive dysfunction, neuropsychological morbidity and pain. To explore the reliability of assessments by carefully chosen proxies, we designed a discriminating selection of proxies and evaluated agreement between patient and proxy responses by assessing activities of daily living (ADLs) at 1 month post-ICU discharge. patients ≥60 years old admitted to the medical ICU were enrolled in a prospective parent cohort studying delirium. Proxies were carefully screened at ICU admission to choose the best available respondent. Follow-up interviews, including instruments for ADLs, were conducted 1 month after ICU discharge. We examined 179 paired patient-proxy follow-up interviews. Kappa statistics assessed inter-observer agreement, and McNemar's exact test assessed response differences. patients averaged 73.3 ± 8.1 years old with 29% having evidence of cognitive impairment. Proxies were most commonly spouses (38%) or children (39%). Overall, there was substantial (κ ≥ 0.6) to excellent agreement (κ ≥ 0.8) between patients and proxies on assessment of all but one basic and one instrumental ADL. proxies carefully chosen at ICU admission show high levels of inter-observer agreement with older patients when assessing current functional status at 1 month post-ICU discharge. This motivates further study of proxy assessments that could be used earlier in critical illness to assess premorbid functional status.

Towards an ADL taxonomy for occupational therapists

One of the main concepts in occupational therapy is human occupation. In occupational therapy there is a need for a common conceptual framework to assess and describe the ability of patients to perform occupational activities of daily living. The aim of this report was to develop a taxonomy concerning the activities of daily living (ADL). In the taxonomy, occupation has been defined and related to common concepts of disability. Ordinary ADL terms have been categorized into three levels: occupational forms, activities and actions. Different actions are components of and subordinated to superior activities. Experience shows that the ADL taxonomy contributes to a valid (content and construct) assessment of ADL, a common language for OTs and to a clearer picture of the patient’s performance in daily life activities.

Effects of Inpatients’ Service Satisfaction on Health-related Quality of Life in Geriatric Hospitals

This study aims at suggesting improvement measures on health-related quality of life for inpatients in geriatric hospitals by analyzing the influences of inpatients’service satisfaction on their health-related quality of life. For this study, a survey was done for inpatients in 15 different geriatric hospitals from 12 February 2013 to 28 February 2013; 307 questionnaires out of the 345 collected questionnaires were used in the final analysis. The results of this study are as follows. First, the average inpatient service satisfaction in geriatric hospitals was 3.81, and the average health-related quality of life was 2.68. Second, inpatient service satisfaction correlated positively with the following three factors: absence of financial pressure for services, lack of visitations from family members and hospitalization period of 3 or more years. Third, medical services satisfaction, facilities and environment satisfaction, which are the sub-categories factor of inpatient service satisfaction, had effect on health-related quality of life. Fourth, the level of the health-related quality of life tended to increase as the following four factors increase: health status, the level of religious devotion, the level of ADL(Activities of Daily Living) assessment, and the level of medical services satisfaction, facilities and environment satisfaction. Based on the results above, the measures to improve health-related quality of life are suggested as follows. First, geriatric hospitals should search for the measures to strengthen their inpatients’ health status by expanding and improving diverse programs for enhancing inpatients’ health because the health-related quality of life is directly affected by health status and ADL assessment. Second, geriatric hospitals should improve the education, training and qualification of their personnels in order to raise the level of inpatients’ service satisfaction. Third, geriatric hospitals should maintain active and cooperative relationship with religious organizations in order to develop and manage effective support programs for the elderly.

The inclusion of activities of daily living in flexor tendon rehabilitation: A survey

Studies have shown that patients restricted to one-handed use due to trauma or surgery often have difficulty with activities of daily living (ADLs). In order to assess hand therapists' perspectives and practices regarding ADL assessment and intervention, a 21-item survey was e-mailed to members of the American Society of Hand Therapists (ASHT). Results of the survey indicate that the majority of hand therapists surveyed (97.5%) feel that ADL performance is an important part of hand therapy practice and that teaching adaptive strategies is a high priority in the early weeks of flexor tendon rehabilitation, but less than half (45.5%) actually provide a formal assessment of ADL performance in order to discover patients' ADL needs. Reasons for this discrepancy between beliefs and practices are explored through participants' comments in the survey. Level of evidence: 3b.

Prospective study of activities of daily living outcomes in children with cerebellar atrophy

The aim of this study was to identify clinical and radiological predictors of activities of daily living (ADL) outcomes in children with cerebellar atrophy. Over a period of 5 years, we evaluated 44 participants (25 males, 19 females) children with confirmed cerebellar atrophy using magnetic resonance imaging (MRI). The median age at the time of assessment 9 years; range 16 mo-18y. Participants were grouped according to whether the cerebellar atrophy was isolated or associated with other radiological abnormalities. Severity of cerebellar atrophy was graded using qualitative and quantitative scoring systems. A standardized ADL assessment was used to characterize functional outcomes. The characteristics of the participants were analysed using descriptive statistics. The mean age at symptom onset was 20 months (range birth-10y). The group with isolated cerebellar atrophy had better outcomes than the group with cerebellar atrophy associated with other radiological abnormalities, with a mean total ADL score difference of 8.0 points (95% confidence interval 1.8-14.2 points, p=0.01). Age at onset of cerebellar atrophy before 2 years of age, progression of cerebellar atrophy on magnetic resonance imaging, presence of seizures, and decreased size of transverse cerebellar hemisphere diameter were all associated with worse outcomes. We present a prospective study of clinical and radiological predictors of ADL outcome in children with cerebellar atrophy. This information may be useful in the diagnosis and future management of this complex group of disorders.

3D motion capture using the HUX model for monitoring functional changes with arthroplasty in patients with degenerative osteoarthritis

BackgroundAlthough shoulder hemiarthroplasty (SHA) can improve function in osteoarthritic shoulders, the ability to perform activities of daily living (ADL) may remain impaired. Shoulder surgeons routinely measure parameters such as range of motion, pain, satisfaction and strength. A common subjective assessment of ADL is part of the Constant Score (CS). However, there is limited objective evidence on whether or not shoulder hemiarthroplasty can restore normal range of motion (ROM) in ADL. MethodsThe study included eight consecutive patients (n=8; seven women, one man), who underwent SHA for glenohumeral osteoarthritis. The patients were examined the day before, as well as 6 months and 3 years after shoulder replacement. They were compared with a control group with no shoulder pathology, and shoulder movement was measured with 3D motion analysis using the “Heidelberg Upper Extremity” (HUX) model. Measurements included static maximum values and four ADL. ResultsComparing the preoperative to the 3-year postoperative static maximum values, there were significant improvements for abduction from 50.5° (SD ±32.4°) to 72.4° (SD ±38.2°; p=0.031), for adduction from 6.2° (SD ±7.7°) to 66.7° (SD ±18.0°; p=0.008), for external rotation from 15.1° (SD ±27.9°) to 50.9° (SD ±27.3°; p=0.031), and for internal rotation from −0.6° (SD ±3.9°) to 35.8° (SD ±28.2°; p=0.031). There was a trend of improvement for flexion from 105.8° (SD ±45.7°) to 161.9° (SD ±78.2°; p=0.094) and for extension from 20.6° (SD ±17.0°) to 28.0° (SD ±12.5°; p=0.313). The comparison of the 3-year postoperative ROM between the SHA group and controls showed significant differences in abduction; 3-year postoperative SHA ROM 72.4° (SD ±38.2°) vs. 113.5° (SD ±29.7°) among controls (p=0.029). There were no significant differences compared to the control group in adduction, flexion/extension and rotation 3 years after SHA surgery. In performing the ADL, the pre- to the 6-month and 3-year postoperative status of the SHA group resulted in a significant increase in ROM in all planes (p<0.05). Comparing the preoperative to the 3-year postoperative ROM used in ADL, there was an improvement in the flexion/extension plane, showing an improvement trend from preoperative 85°−0°−25° to postoperative 127°−0°−38° (p=0.063). In comparison, controls used a significantly greater ROM during ADL with mean flexion/extension of 139°−0°−63° (p=0.028). For the abduction/adduction plane, ROM improved significantly from preoperative 25°−0°−19° to postoperative 78°−0°−60° (p=0.031). In comparison to controls with abduction/adduction of 118°−0°−37° 3 years postoperative, the SHA group also used significantly less ROM in the abduction/adduction plane (p=0.028). ConclusionWhile SHA improves ROM in ADL in patients with degenerative glenohumeral osteoarthritis, it does not restore the full ROM available for performing ADL compared to controls. 3D motion analysis with the HUX model is an appropriate measurement system to detect surgery-related changes in shoulder arthroplasty.

A systematic review of the psychometric properties of self‐reported scales assessing burn contractures reveals the need for a new tool to measure contracture outcomes

Approximately 40% of burn patients develop scar contractures. It is unknown which scar contracture therapy best optimizes activities of daily living (ADL).The appropriateness of self-reported outcome tools in measuring anti-scar contracture therapies has not been assessed. We conducted a systematic review to determine the quality of existing self-reported scales in measuring ADL among burn patients by analyzing and comparing psychometric properties-factor analysis, validity, reliability, and responsiveness. EMBASE, LILACS, American Psychological Association PsycNET databases were searched for relevant articles. Forty-one articles discussing 10 burn and non-burn-specific scales met eligibility criteria of ADL assessment, and available psychometric analyses. A common strength in most scales was good overall reliability. Common weaknesses were insufficient data on factor analyses, content validity specific to ADL assessment, and responsiveness. The psychometric analyses studies on these scales had poor sample variability. There is insufficient data on the dimensionality and responsiveness of existing scales to support their use for measuring ADL in burn patients. Existing scales do not comprehensively measure ADLs as an isolated parameter. A psychometrically valid, comprehensive self-reported burn contracture scale that measures ADLs among a diverse group of burn patients needs to be developed to optimize burn contracture treatments and develop new therapies.

What is the utility of preoperative frailty assessment for risk stratification in cardiac surgery?

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether frailty scoring can be used either separately or combined with conventional risk scores to predict survival and complications. Five hundred and thirty-five papers were found using the reported search, of which nine cohort studies represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. There is a paucity of evidence, as advanced age is a criterion for exclusion in most randomized controlled trials. Conventional models of risk following cardiac surgery are not calibrated to accurately predict the outcomes in the elderly and do not currently include frailty parameters. There is no universally accepted definition for frailty, but it is described as a physiological decline in multiple organ systems, decreasing a patient's capacity to withstand the stresses of surgery and disease. Frailty is manifest clinically as deficits in functional capacity, such as slow ambulation and impairments in the activities of daily living (ADL). Analysis of predictive models using area under receiver operating curves (AUC) suggested only a modest benefit by adding gait speed to a Society of Thoracic Surgeons (STS score)-Predicted Risk of Mortality or Major Morbidity (PROM) risk score (AUC 0.04 mean difference). However, a specialist frailty assessment tool named FORECAST was found to be superior at predicting adverse outcomes at 1 year compared with either EuroSCORE or STS score (AUC 0.09 mean difference). However, risk models incorporating frailty parameters require further validation and have not been widely adopted. Routine collection of objective frailty measures such as 5-metre walk time and ADL assessment will help to provide data to develop new risk-assessment models to facilitate risk stratification and clinical decision-making in elderly patients. Based on the best evidence currently available, we conclude that frailty is an independent predictor of adverse outcome following cardiac surgery or transcatheter aortic valve implantation, increasing the risk of mortality 2- to 4-fold compared with non-frail patients.

Development of a Computerized Adaptive Test for Assessing Activities of Daily Living in Outpatients With Stroke

An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. The purpose of this study was to construct a computerized adaptive testing (CAT) system for measuring ADL function in outpatients with stroke. Two cohort studies were conducted at 6 hospitals in Taiwan. A candidate item bank (44 items) was developed, and 643 outpatients were interviewed. An item response theory model was fitted to the data and estimated the item parameters (eg, difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. Two stopping rules (ie, reliability coefficient >.9 and maximum test length of 7 items) were set for the CAT. The participants' ADL scores had an average reliability of .93. The CAT scores were highly associated with those of the full 34 items (Pearson r=.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=.82). The time required to complete the CAT was about one fifth of the time used to administer both the BI and FAI. The participants were outpatients living in the community. Further studies are needed to cross-validate the results. The results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.

Functional level at admission is a predictor of survival in older patients admitted to an acute geriatric unit

BackgroundFunctional decline is associated with increased risk of mortality in geriatric patients. Assessment of activities of daily living (ADL) with the Barthel Index (BI) at admission was studied as a predictor of survival in older patients admitted to an acute geriatric unit.MethodsAll first admissions of patients with age >65 years between January 1st 2005 and December 31st 2009 were included. Data on BI, sex, age, and discharge diagnoses were retrieved from the hospital patient administrative system, and data on survival until September 6th 2010 were retrieved from the Civil Personal Registry. Co-morbidity was measured with Charlson Co-morbidity Index (CCI). Patients were followed until death or end of study.Results5,087 patients were included, 1,852 (36.4%) men and 3,235 (63.6%) women with mean age 81.8 (6.8) and 83.9 (7.0) years respectively. The median [IQR] length of stay was 8 days, the median follow up [IQR] 1.4 [0.3; 2.8] years and in hospital mortality 8.2%. Mortality was greater in men than in women with median survival (95%-CI) 1.3 (1.2 -1.5) years and 2.2 (2.1-2.4) years respectively (p < 0.001). The median survivals (95%-CI) stratified on BI groups in men (n = 1,653) and women (n = 2,874) respectively were: BI 80-100: 2.6 (1.9-3.1) years and 4.5 (3.9-5.4) years; BI 50-79: 1.7 (1.5-2.1) years and 3.1 (2.7-3.5) years; BI 25-49: 1.5 (1.3-1.9) years and 1.9 (1.5-2.2) years and BI 0-24: 0.5 (0.3-0.7) years and 0.8 (0.6-0.9) years. In multivariate logistic regression analysis with BI 80-100 as baseline and controlling for significant covariates (sex, age, CCI, and diseases of cancer, haematology, cardiovascular, respiratory, infectious and bone and connective tissues) the odds ratios for 3 and 12 months survival (95%-CI) decreased with declining BI: BI 50-79: 0.74 (0.55-0.99) (p < 0.05) and 0,80 (0.65-0.97)(p < 0.05); BI 25-49: 0.44 (0.33-0.59)(p < 0.001) and 0.55 (0.45-0.68)(p < 0.001); and BI 0-24: 0.18 (0.14-0.24)(p < 0.001) and 0.29 (0.24-0.35)(p < 0.001) respectively.ConclusionBI is a strong independent predictor of survival in older patients admitted to an acute geriatric unit. These data suggest that assessment of ADL may have a potential role in decision making for the clinical management of frail geriatric inpatients.

Ageing Challenges the Results of any Outcome Study: How to Address the Effects of Ageing on Activities of Daily Living

Clinical study results might be substantially biased by the effects of ageing, resulting in considerable underestimation of treatment efficacy, especially when assessing activities of daily living (ADL) in elderly people. This study aimed to define age- and comorbidity-related normative values in ADL. In cross-sectional sampling, 23 763 German-speaking Swiss individuals were contacted. Valid questionnaires from 16 191 (68%) eligible individuals ≥ 18 years of age were included in the study. Age-related ADL reference values were calculated using questionnaire data. The sample was representative of the German-speaking Swiss population as determined by 2003 census data. Age- and pain-related ADL reference values were plotted and confirmed that disability increased with increasing age. The use of ADL scales that provide age- and comorbidity-related reference values for outcome studies or studies focusing on the elderly is recommended in order to reduce the effect of bias.

Impact of physical activity on activity of daily living in moderate to severe dementia: a critical review.

The objectives of this study were to describe the different modalities of physical activity programs designed for moderate to severe dementia and to identify their impact on functional independence in activities of daily living (ADL). A critical review of randomized controlled trials related to the impact of physical activity programs in moderately to severely demented persons on ADL performance and meta-analysis of the identified studies were performed. Among the 303 identified articles, five responded to the selection criteria. Four out of the five studies demonstrated limited methodological quality. In one high-quality study, physical activity programs significantly delayed deterioration of ADL performance. The program components and ADL assessment tools vary widely across studies. Although the proposed treatments have not proven their efficiency in improving the ADL status of the patients, they were able to limit the decline in ADL functioning. Future research is warranted in order to identify clinically relevant modalities for physical activity programs for people with moderate to severe dementia.

Analyse Critique D'instruments de Mesure Des AVQ en Pédiatrie: Déficits Exécutifs et Indépendance

Although the assessment of the activities of daily living (ADL) through task analysis is central to the role of the occupational therapists working with children with traumatic brain injury (TBI), no review has revealed any study aimed at analyzing the instruments used to this effect, in regard to their potential to highlight the deficits associated with the executive functions (e.g., formulate a goal, planning). To determine if any ADL assessment tools validated for children 10 to 15 years with a TBI consider executive functions. Four tools, i.e., "Assessment of Motor and Process Skills' the "Children's Kitchen Task Assessment', the "Chocolate Cake Task" and the "ADL Profile' were analyzed according to the following criteria: 1) complexity of the tasks, 2) non-structured assessment method, and 3) psychometric properties appropriate for the target population. These tools are only partially consistent with the desired criteria. Further research on these tools will be necessary to meet the needs of this population.

Activities of daily living are associated with older adult cognitive status: caregiver versus self-reports.

We compared the extent to which subjective report of activities of daily living (ADLs) by caregivers and older adults were associated with objective measures of older adults' cognition. In independent studies (Study 1 N = 238; Study 2 N = 295), bivariate correlations and multiple regression analyses examined the association of caregiver and self-rated reports of older adult basic, instrumental, and total ADLs and older adult cognition. We examined the magnitude of the caregiver/self-report discrepancy and older adult cognition. In both studies, caregiver reports more accurately accounted for older adult cognitive differences. Older adult visuospatial/constructional deficits were uniquely related to caregiver basic ADL reports. Results indicate that caregiver reports of older adult ADLs are more reliable indicators of older adult cognition than self-reports, and this difference grows as older adult cognition decreases. Thus, older adult ADL assessment may be useful in providing information on potential cognitive decline.

A Prospective, Open-Label, 12 Week Trial of S-adenosylmethionine in the Symptomatic Treatment of Alzheimer’s Disease

Objective: To determine if treatment with S-adenosylmethionine (SAM-e) might lead to cognitive and behavioral improvement in patients with Alzheimer’s disease (AD). Interventions: We conducted a prospective, open-label study of six subjects who were given oral SAM-e over 12 weeks and measured the effects on cognition and behavior. Outcome measures: Outcome measures of cognition and behavior included the Alzheimer’s Disease Assessment Scale-Cognitive subscale (ADAS-Cog), Mini-Mental State Examination (MMSE), Behave-AD, Clinical Global Impression Scale (CGI), Hamilton Rating Scale for Depression (HAM-D), informant version, Blessed Dementia Scale to assess activities of daily living (ADL), the Physical Self-Maintainance Scale (PSMS), and the Lawton-Brody IADL Scale to measure instrumental activities of daily living. Results: At study completion, two subjects were “moderately improved” and 4 were “minimally improved” on the CGI. Five subjects improved on the ADAS-Cog by an average of 20%. No significant side effects were reported. Conclusions: In this small open label study, SAM-e appeared to have a beneficial effect in patients with AD, but the small subject number didn’t provide enough power to show statistical significance. Controlled trials with adequate statistical power to investigate its utility in AD are warranted.

Disability in activities of daily living, depression, and quality of life among older medical ICU survivors: a prospective cohort study

BackgroundAccurate measurement of quality of life in older ICU survivors is difficult but critical for understanding the long-term impact of our treatments. Activities of daily living (ADLs) are important components of functional status and more easily measured than quality of life (QOL). We sought to determine the cross-sectional associations between disability in ADLs and QOL as measured by version one of the Short Form 12-item Health Survey (SF-12) at both one month and one year post-ICU discharge.MethodsData was prospectively collected on 309 patients over age 60 admitted to the Yale-New Haven Hospital Medical ICU between 2002 and 2004. Among survivors an assessment of ADL's and QOL was performed at one month and one-year post-ICU discharge. The SF-12 was scored using the version one norm based scoring with 1990 population norms. Multivariable regression was used to adjust the association between ADLs and QOL for important covariates.ResultsOur analysis of SF-12 data from 110 patients at one month post-ICU discharge showed that depression and ADL disability were associated with decreased QOL. Our model accounted for 17% of variability in SF12 physical scores (PCS) and 20% of variability in SF12 mental scores (MCS). The mean PCS of 37 was significantly lower than the population mean whereas the mean MCS score of 51 was similar to the population mean. At one year mean PCS scores improved and ADL disability was no longer significantly associated with QOL. Mortality was 17% (53 patients) at ICU discharge, 26% (79 patients) at hospital discharge, 33% (105 patients) at one month post ICU admission, and was 45% (138 patients) at one year post ICU discharge.ConclusionsIn our population of older ICU survivors, disability in ADLs was associated with reduced QOL as measured by the SF-12 at one month but not at one year. Although better markers of QOL in ICU survivors are needed, ADLs are a readily observable outcome. In the meantime, clinicians must try to offer realistic estimates of prognosis based on available data and resources are needed to assist ICU survivors with impaired ADLs who wish to maintain their independence. More aggressive diagnosis and treatment of depression in this population should also be explored as an intervention to improve quality of life.

Reliability and the measurement of activity limitations (ADLs) for children with special health care needs (CSHCN) living in the community

Purpose. Meeting the personal care challenges of children with special health care needs (CSHCN) living in the community demands a reliable assessment of their abilities to perform activities of daily living (ADLs). This research investigates factors affecting the inter-rater reliability of functional assessments of CSHCN conducted in the home.Methods. Dual-standardised assessments were conducted with 236 community-dwelling CSHCN seeking or receiving Medicaid Personal Care Services (PCS) in a single state in USA.Results. Analyses revealed that assessments of CSHCN with the greatest or least amount of activity limitations exhibited the greatest agreement. The greatest disagreement occurred when assessors faced children with moderate to moderately severe activity limitations. Specific ADLs, where the greatest and least agreements occurred, varied by the level of the child's overall activity limitation.Conclusions. These results imply that the most serious challenges to the reliability of home-based assessment of ADLs among CSHCN occur in cases of children with moderate or moderately severe activity limitations.

Utility of the Functional Activities Questionnaire for Distinguishing Mild Cognitive Impairment From Very Mild Alzheimer Disease

Current criteria for mild cognitive impairment (MCI) require "essentially intact" performance of activities of daily living (ADLs), which has proven difficult to operationalize. We sought to determine how well the Functional Activities Questionnaire (FAQ), a standardized assessment of instrumental ADLs, delineates the clinical distinction between MCI and very mild Alzheimer disease (AD). We identified 1801 individuals in the National Alzheimer's Coordinating Center Uniform Data Set with MCI (n=1108) or very mild AD (n=693) assessed with the FAQ and randomized them to the development or test sets. Receiver-operator curve (ROC) analysis of the development set identified optimal cut-points that maximized the sensitivity and specificity of FAQ measures for differentiating AD from MCI and were validated with the test set. ROC analysis of total FAQ scores in the development set produced an area under the curve of 0.903 and an optimal cut-point of 5/6, which yielded 80.3% sensitivity, 87.0% specificity, and 84.7% classification accuracy in the test set. Bill paying, tracking current events, and transportation (P's<0.005) were the FAQ items of greatest diagnostic utility. These data suggest that the FAQ exhibits adequate sensitivity and specificity when used as a standardized assessment of instrumental ADLs in the diagnosis of AD versus MCI.

Performance-based assessment of activities of daily living (ADL) ability among women with chronic widespread pain

Functional ability, including the ability to perform activities of daily living (ADL), is considered a core outcome domain in chronic pain clinical trials and is usually assessed through generic or disease-specific self-report questionnaires. Research, however, indicates that self-report and performance-based assessment of ADL offer distinct but complementary information about ability. The present study, therefore, investigated the applicability of a performance-based measure of ADL ability, the Assessment of Motor and Process Skills (AMPS), among 50 women with chronic widespread pain. The investigated psychometric properties of the AMPS included discrimination between a sample of healthy women and those with chronic widespread pain, as well as stability when no intervention was provided and sensitivity to change following intervention. Data were obtained based on a repeated measures design performing AMPS evaluations twice pre- and twice post-rehabilitation. Results indicated that the ADL motor ability measures of the participants were significantly lower than those of healthy women of same age, the ADL motor and ADL process ability measures remained stable when no intervention was provided and the ADL motor ability measures were sensitive to change following a 2-week interdisciplinary rehabilitation program. A weak correlation ( r s = −0.35) was found between self-reported ADL ability as measured by the physical function subscale of the Functional Impact Questionnaire (FIQ) and performance-based ADL motor measures, and no correlation ( r s = −0.02) was found between FIQ ADL measures and ADL process ability, supporting the need for both performance-based and self-reported assessment of ADL.

Factors underlying impairment on activities of daily living in behavioral variant frontotemporal dementia

Event Abstract Back to Event Factors underlying impairment on activities of daily living in behavioral variant frontotemporal dementia J. R. Hodges1, M. Hornberger1, C. M. Kipps2 and E. Mioshi1* 1 Prince of Wales Medical Research Institute, Australia 2 Southampton University NHS Trust, Wessex Neurological Centre, United Kingdom Patients with the behavioral variant of frontotemporal dementia (bvFTD) have marked impairment in everyday life, yet little is known about factors underlying this impairment. Moreover, a recently identified FTD subgroup with normal brain imaging shows an excellent prognosis (phenocopy cases) and their performance on activities of daily living (ADL) tasks is unknown. Eighteen bvFTD patients (phenocopy: n=10; pathological: n=8. Classification was based on atrophy on MRI scans, which were kept blind for the ADL assessment) were assessed on the Assessment of Motor and Process Skills, a standardized performance-based activity of daily living instrument. Apathy, executive dysfunction and disinhibition, as measured by the Frontal Systems Behavioural Scale, carer version (FrSBe), global cognition (Addenbrooke’s Cognitive Examination, ACE-R), and visual MRI brain atrophy were also evaluated. There was a significant association between the ADL measure and the atrophy on the frontal lobes (r= -0.549; p <0.05). Only frontal atrophy on MRI scans explained the variance of ADL scores; no variable measured by the FrSBe entered the regression model. Performance on the ADL assessment could distinguish between phenocopy and pathological patients (78.8%). Although phenocopy and pathological bvFTD patients present with similar symptomatology, performance-based assessment of ADLs can aid in the differential diagnosis of bvFTD. Conference: The 20th Annual Rotman Research Institute Conference, The frontal lobes, Toronto, Canada, 22 Mar - 26 Mar, 2010. Presentation Type: Poster Presentation Topic: Neurorehabilitation Citation: Hodges JR, Hornberger M, Kipps CM and Mioshi E (2010). Factors underlying impairment on activities of daily living in behavioral variant frontotemporal dementia. Conference Abstract: The 20th Annual Rotman Research Institute Conference, The frontal lobes. doi: 10.3389/conf.fnins.2010.14.00127 Copyright: The abstracts in this collection have not been subject to any Frontiers peer review or checks, and are not endorsed by Frontiers. They are made available through the Frontiers publishing platform as a service to conference organizers and presenters. The copyright in the individual abstracts is owned by the author of each abstract or his/her employer unless otherwise stated. Each abstract, as well as the collection of abstracts, are published under a Creative Commons CC-BY 4.0 (attribution) licence (https://creativecommons.org/licenses/by/4.0/) and may thus be reproduced, translated, adapted and be the subject of derivative works provided the authors and Frontiers are attributed. For Frontiers’ terms and conditions please see https://www.frontiersin.org/legal/terms-and-conditions. Received: 30 Jun 2010; Published Online: 30 Jun 2010. * Correspondence: E. Mioshi, Prince of Wales Medical Research Institute, Sydney, Australia, e.mioshi@powmri.edu.au Login Required This action requires you to be registered with Frontiers and logged in. To register or login click here. Abstract Info Abstract The Authors in Frontiers J. R Hodges M. Hornberger C. M Kipps E. Mioshi Google J. R Hodges M. Hornberger C. M Kipps E. Mioshi Google Scholar J. R Hodges M. Hornberger C. M Kipps E. Mioshi PubMed J. R Hodges M. Hornberger C. M Kipps E. Mioshi Related Article in Frontiers Google Scholar PubMed Abstract Close Back to top Javascript is disabled. Please enable Javascript in your browser settings in order to see all the content on this page.