Frenchay Activities Index Research Articles

Long-term performance of instrumental activities of daily living (IADL) in young and middle-aged stroke survivors: Results from SAHLSIS outcome

Background: Although stroke prevalence is increasing and large proportions of stroke survivors are expected to live many years after stroke onset, research on the long-term consequences of stroke for instrumental activities of daily living (IADL) is limited.Aim: To explore performance of IADL seven years post-stroke onset and identify predictors of long-term IADL performance based on commonly employed acute measures and demographic characteristics in young and middle-aged stroke survivors.Methods: Data on stroke survivors were collected from SAHLSIS. IADL performance was assessed at 7 years using the Frenchay Activities Index (FAI). Demographic data and baseline measures were assessed as predictors of FAI outcome, using logistic regression.Results: 237 stroke survivors with a median age of 63 at follow-up were included. Participants had predominantly suffered a mild stroke and >90% lived at home with no community services. Mean FAI was 25.7(score range 0-45), indicating reduced levels of participation in IADL. Frequency of performance of IADL was lowest for work/leisure activities. Gender, cohabitation status, initial stroke severity and baseline score on mRS were independently associated with IADL outcome.Conclusions: Reduced levels of participation in IADL persist many years after stroke onset and indicate a need to adapt a long-term perspective on stroke rehabilitation.

Long-term Outcome After Survival of a Cardiac Arrest: A Prospective Longitudinal Cohort Study

Background. A cardiac arrest can lead to hypoxic brain injury, which can affect all levels of functioning. Objective. To investigate 1-year outcome and the pattern of recovery after surviving a cardiac arrest. Methods. This was a multicenter, prospective longitudinal cohort study with 1 year of follow-up (measurements 2 weeks, 3 months, 1 year). On function level, physical/cardiac function (New York Heart Association Classification), cognition (Cognitive Log [Cog-log], Cognitive Failures Questionnaire), emotional functioning (Hospital Anxiety and Depression Scale, Impact of Event Scale), and fatigue (Fatigue Severity Scale) were assessed. In addition, level of activities (Frenchay Activities Index, FAI), participation (Community Integration Questionnaire [CIQ] and return to work), and quality of life (EuroQol 5D, EuroQol Visual Analogue Scale, SF-36, Quality of Life after Brain Injury) were measured. Results. In this cohort, 141 cardiac arrest survivors were included. At 1 year, 14 (13%) survivors scored below cutoff on the Cog-log. Both anxiety and depression were present in 16 (15%) survivors, 29 (28%) experienced posttraumatic stress symptoms and 55 (52%), severe fatigue. Scores on the FAI and the CIQ were, on average, respectively 96% and 92% of the prearrest scores. Of those previously working, 41 (72%) had returned to work. Most recovery of cognitive function and quality of life occurred within the first 3 months, with further improvement on some domains of quality of life up to 12 months. Conclusions. Overall, long-term outcome in terms of activities, participation, and quality of life after cardiac arrest is reassuring. Nevertheless, fatigue is common; problems with cognition and emotions occur; and return to work can be at risk.

Validation of the Frenchay activity index on stroke victims.

To evaluate the inter-rater reliability and predictive validity of the Frenchay Activities Index (FAI) in patients after stroke. One hundred sixty-one patients were selected for consecutive application of the FAI and National Institutes of Health Stroke Scale (NIHSS). Spearman's test was used for correlation between different scales. The FAI and NIHSS association was evaluated using ordinal logistic regression. Additionally, 36 patients underwent FAI rating on the same day by two independent evaluators. A negative correlation between the FAI and the NIHSS scores (p = 0.017 r = -0.22) was found. Adjusting all variables with possible association with the NIHSS, ordinal logistic regression showed that the FAI had a significant association with NIHSS scores (OR 0.93, 95% CI 0.87 to 0.99, p: 0.033). The inter-rater agreement was considered good, k = 0.66 (0.54 to 0.78), p < 0.001. The FAI is a valid and useful method to assess instrumental activities before acute stroke in a Brazilian population.

Cohort Randomised Controlled Trial of a Multifaceted Podiatry Intervention for the Prevention of Falls in Older People (The REFORM Trial).

BackgroundFalls are a major cause of morbidity among older people. A multifaceted podiatry intervention may reduce the risk of falling. This study evaluated such an intervention.DesignPragmatic cohort randomised controlled trial in England and Ireland. 1010 participants were randomised (493 to the Intervention group and 517 to Usual Care) to either: a podiatry intervention, including foot and ankle exercises, foot orthoses and, if required, new footwear, and a falls prevention leaflet or usual podiatry treatment plus a falls prevention leaflet. The primary outcome was the incidence rate of self-reported falls per participant in the 12 months following randomisation. Secondary outcomes included: proportion of fallers and those reporting multiple falls, time to first fall, fear of falling, Frenchay Activities Index, Geriatric Depression Scale, foot pain, health related quality of life, and cost-effectiveness.ResultsIn the primary analysis were 484 (98.2%) intervention and 507 (98.1%) control participants. There was a small, non statistically significant reduction in the incidence rate of falls in the intervention group (adjusted incidence rate ratio 0.88, 95% CI 0.73 to 1.05, p = 0.16). The proportion of participants experiencing a fall was lower (49.7 vs 54.9%, adjusted odds ratio 0.78, 95% CI 0.60 to 1.00, p = 0.05) as was the proportion experiencing two or more falls (27.6% vs 34.6%, adjusted odds ratio 0.69, 95% CI 0.52 to 0.90, p = 0.01). There was an increase (p = 0.02) in foot pain for the intervention group. There were no statistically significant differences in other outcomes. The intervention was more costly but marginally more beneficial in terms of health-related quality of life (mean quality adjusted life year (QALY) difference 0.0129, 95% CI -0.0050 to 0.0314) and had a 65% probability of being cost-effective at a threshold of £30,000 per QALY gained.ConclusionThere was a small reduction in falls. The intervention may be cost-effective.Trial RegistrationISRCTN ISRCTN68240461

Interrelationship among the health-related and subjective quality of life, daily life activities, instrumental activities of daily living of community-dwelling elderly females in orthopedic outpatients.

[Purpose] This study aimed to examine the health-related and subjective quality of life of community-dwelling elderly females in orthopedic outpatients, and also examined how such quality of life correlate with their daily life activities and instrumental activities of daily living. [Subjects and Methods] Subjects were 27 community-dwelling elderly females in orthopedic outpatients (mean age: 76.3 ± 7.4 years). Their health-related quality of life and subjective quality of life, life-space assessment, frenchay activities index were researched. [Results] For the relationships between the total subjective quality of life scores and health-related quality of life scores, significant positive correlations were observed for body pain, general health, vitality, social functions and mental health. The correlations were not statistically significant between the subjective quality of life scores and the life-space assessment and frenchay activities index scores. The correlations were statistically significant between some health-related quality of life scores and the life-space assessment and frenchay activities index scores. [Conclusion] The results suggest that supporting community-dwelling elderly females in orthopedic outpatients to improve their sense of physical and mental well-being, and prevent and reduce their depression and physical pain, is required in order to improve their QOL.

Effects of perioperative factors and hip geometry on hip abductor muscle strength during the first 6 months after anterolateral total hip arthroplasty.

[Purpose] The importance and effect of hip joint geometry on hip abductor muscle strength are well known. In addition, other perioperative factors are also known to affect hip abductor muscle strength. This study examined the relative importance of factors affecting hip abductor muscle strength after total hip arthroplasty. [Subjects and Methods] The subjects were 97 females with osteoarthritis scheduled for primary unilateral THA. The following variables were assessed preoperatively and 2 and 6 months after surgery: isometric hip abductor strength, radiographic analysis (Crowe class, postoperative femoral offset (FO)), Frenchay Activities Index, compliance rate with home exercise, Japanese Orthopaedic Association Hip-Disease Evaluation Questionnaire (JHEQ), and demographic data. Factors related to isometric hip abductor muscle strength 2 and 6 months after surgery were examined. [Results] Significant factors related to isometric hip abductor muscle strength at 2 and 6 months after surgery were, in extraction order: 1. isometric hip abductor muscle strength in the preoperative period; 2. BMI; and 3. the JHEQ mental score at 2 and 6 months after surgery. [Conclusion] Preoperative factors and postoperative mental status were related to postoperative isometric hip abductor strength. FO was not extracted as a significant factor related to postoperative isomeric hip abductor strength.

Simulation study of activities of daily living functions using online computerized adaptive testing.

BackgroundComputer adaptive testing (CAT) of the activities of daily living (ADL) functions is required (i) to reveal the advantages of using an efficient and accurate estimation method, (ii) to determine the cutpoint for classifying ADL strata in patients with stroke, and (iii) to evaluate the feasibility of online CAT used in clinical settings for smartphones.MethodsNormally standardized distributions of ADL measurements were simulated using item parameters from published papers. We retrieved item parameters of the combined Barthel Index and Frenchay Activities Index from the literature (the 23-item comprehensive ADL [CADL] and 34-item ADL scales) and simulated three 1000-person measures from a normal standard CAT distribution: [i] CADL (CADL-CAT), [ii] ADL (ADL-CAT), and [iii] NAT (Non-Adaptive Testing). The cutpoints of ADL person strata were determined using a norm-reference method. Maximum a posteriori estimation, expected a posteriori estimation, and maximum likelihood estimation (MAP) were used to compare the Pearson correlation coefficients and different number ratios of paired measures yielded by CAT and NAT. The number of items and the cutpoints for the scale were separately determined.ResultsWe found that (i) correlation coefficients for the three CAT-estimated measures were 0.77 (CADL), 0.93 (Male ADL), and 0.93 (Female ADL) compared with their NAT counterparts. Different number ratios of person-paired measures between CAT and NAT for the three scales were all less than 5 %, indicating no difference exists between CAT and NAT. However, CAT might be 66 % more efficient than NAT. (ii) The estimated cutpoints of T scores (i.e., with a mean of 50 and a standard deviation of 10) were 45, 55, and 65 (e.g., separating person ADL function to four strata with not active, fairly active, active, and very active). (iii) An available-for-download online ADL-CAT APP for clinical practice was demonstrated.ConclusionsAn online ADL-CAT APP using the MAP method was created and used on smartphones to classify ADL strata in patients with stroke.Electronic supplementary materialThe online version of this article (doi:10.1186/s12911-016-0370-8) contains supplementary material, which is available to authorized users.

Do Commonly Used Functional Outcome Measures Capture Activities that Are Relevant for People with Stroke in India?

Objectives: In India, post-stroke outcomes are determined using functional outcome measures (FOMs), the contents of which have not been validated for their relevance to the Indian population. In this study, we aimed to evaluate the cultural validity of five frequently used stroke-specific FOMs by comparing their contents with the problems reported by patients with stroke in India.Methods: Face-to-face structured interviews were conducted with 152 patients diagnosed with stroke in India. Problems and goals identified by the patients were compared to each item included in the FOMs used in stroke rehabilitation.Results: The Stroke Impact Scale (SIS) and the Frenchay Activities Index (FAI) include items related to the most frequently identified problems. However, neither covers problems related to the need for squatting and sitting on the floor. Use of public transport and community walking are not included in the SIS. Leisure and recreational activities (e.g. gardening, reading books), cognitive and speech functions (e.g. memory, thinking) and bowel and bladder dysfunctions were the common items identified as “not a problem” or “not relevant” by the patients.Discussion: Our findings suggest that the SIS and FAI are the most appropriate FOMs for patients with stroke in India as they include items related to the majority of problems identified by study participants. Many items on both measures, however, were identified as not a problem or not relevant. There is a need for developing culture-specific FOMs that incorporate all major concerns expressed by patients with stroke in India.

Validation of Frenchay Activity Index Among Older Veterans with Gait and Balance Deficits

This study examines the validity of the Frenchay Activity index (FAI) when used to measure participation in a group of community dwelling older Veterans with gait and balance deficits.

Self-Reported Fatigue and Associated Factors Six Years after Stroke.

Several studies have found that fatigue is one of the most commonly reported symptoms after stroke and the most difficult to cope with. The present study aimed to investigate the presence and severity of self-reported fatigue six years after stroke onset and associated factors. The cohort “Life After Stroke Phase I” (n = 349 persons) was invited at six years to report fatigue (Fatigue Severity Scale 7-item version), perceived impact of stroke and global recovery after stroke (Stroke Impact Scale), anxiety and depression (Hospital Anxiety and Depression Scale), life satisfaction (Life Satisfaction Checklist) and participation in everyday social activities (Frenchay Activities Index). At six years 37% of the 102 participants in this cross-sectional study reported fatigue. The results showed that in nearly all SIS domains the odds for post-stroke fatigue were higher in persons with a higher perceived impact. Furthermore, the odds for post-stroke fatigue were higher in those who had experienced a moderate/severe stroke and had signs of depression and anxiety. Fatigue is still present in one-third of persons as long as six years after stroke onset and is perceived to hinder many aspects of functioning in everyday life. There is an urgent need to develop and evaluate interventions to reduce fatigue.

What Factors Predict Who Will Have a Strong Social Network Following a Stroke?

Measures of social networks assess the number and nature of a person's social contacts, and strongly predict health outcomes. We explored how social networks change following a stroke and analyzed concurrent and baseline predictors of social networks 6 months poststroke. We conducted a prospective longitudinal observational study. Participants were assessed 2 weeks (baseline), 3 months, and 6 months poststroke. Measures comprised the Stroke Social Network Scale (Northcott & Hilari, 2013), Medical Outcomes Study Social Support Survey (Sherbourne & Stewart, 1991), National Institutes of Health Stroke Scale (Brott et al., 1989), Frenchay Aphasia Screening Test (Enderby, Wood, Wade, & Langton Hewer, 1987), Frenchay Activities Index (Wade, Legh-Smith, & Langton Hewer, 1985), and Barthel Index (Mahoney, Wood, & Barthel, 1958). Analyses of variance and standard multiple regression were used to analyze change and identify predictors. Eighty-seven participants (37% with aphasia) were recruited; 71 (16% with aphasia) were followed up at 6 months. Social network scores declined poststroke (p = .001). Whereas the Children and Relatives factors remained stable, the Friends factor significantly weakened (p < .001). Concurrent predictors of social network at 6 months were perceived social support, ethnicity, aphasia, and extended activities of daily living (adjusted R2 = .42). There were 2 baseline predictors: premorbid social network and aphasia (adjusted R2 = .60). Social networks declined poststroke. Aphasia was the only stroke-related factor measured at the time of the stroke that predicted social network 6 months later.

Return to Work 2-5Years After Stroke: A Cross Sectional Study in a Hospital-Based Population.

Purpose To describe factors associated with RTW in patients 2-5years after stroke. Methods Cross sectional study, including patients 2-5years after hospitalization for a first-ever stroke, who were <65years and had been gainfully employed before stroke. Patients completed a set of questionnaires on working status and educational level, physical functioning (Frenchay Activities Index, FAI), mental functioning (Hospital Anxiety and Depression Scale, HADS), Coping Orientations to Problems Experienced, (COPE easy) and quality of life (Short-Form(SF)-36 and EQ(Euroqol)-5D). Caregivers completed the Caregiver Strain Index (CSI). Baseline stroke characteristics were gathered retrospectively. Baseline characteristics and current health status were compared between patients who did and did not RTW by means of logistic regression analysis with odds ratios (OR) and 95% confidence intervals (CI), adjusted for age and gender. Results Forty-six patients were included, mean age of 47.7years (SD 9.7), mean time since stroke of 36months (SD 11.4); 18 (39%) had RTW. After adjusting for age and gender a shorter length of hospitalization was associated with RTW (OR 0.87; CI 0.77-0.99). Of the current health status, a lower HADS depression score (0.76; 0.63-0.92), a less avoidant coping style (1.99; 0.80-5.00), better scores on the FAI (1.13; 1.03-1.25), the mental component summary score of the SF36 (1.07; 1.01-1.13), the EQ5D (349; 3.33-36687) and the CSI (0.68; 0.50-0.92) were associated with the chance of RTW. Conclusions A minority of working patients RTW after stroke; a shorter duration of the initial hospitalization was associated with a favorable work outcome. The significant association between work status and activities, mental aspects and quality of life underlines the need to develop effective interventions supporting RTW.

Whole-Body Vibration Intensities in Chronic Stroke: A Randomized Controlled Trial.

A single-blinded randomized controlled study was conducted to investigate the effects of different whole-body vibration (WBV) intensities on body functions/structures, activity, and participation in individuals with stroke. Eighty-four individuals with chronic stroke (mean age = 61.2 yr, SD = 9.2) with mild to moderate motor impairment (Chedoke-McMaster Stroke Assessment lower limb motor score: median = 9 out of 14, interquartile range = 7-11.8) were randomly assigned to a low-intensity WBV, high-intensity WBV, or control group. The former two groups performed various leg exercises while receiving low-intensity and high-intensity WBV, respectively. Controls performed the same exercises without WBV. All individuals received 30 training sessions over an average period of 75.5 d (SD = 5.2). Outcome measurements included knee muscle strength (isokinetic dynamometry), knee and ankle joint spasticity (Modified Ashworth Scale), balance (Mini Balance Evaluation Systems Test), mobility (Timed-Up-and-Go test), walking endurance (6-Minute Walk Test), balance self-efficacy (Activities-specific Balance Confidence scale), participation in daily activities (Frenchay Activity Index), perceived environmental barriers to societal participation (Craig Hospital Inventory of Environmental Factors), and quality of life (Short-Form 12 Health Survey). Assessments were performed at baseline and postintervention. Intention-to-treat analysis revealed a significant time effect for muscle strength, Timed-Up-and-Go distance, and oxygen consumption rate achieved during the 6-Minute Walk Test, the Mini Balance Evaluation Systems Test, the Activities-specific Balance Confidence scale, and the Short-Form 12 Health Survey physical composite score domain (P < 0.05). However, the time-group interaction was not significant for any of the outcome measures (P > 0.05). The addition of the 30-session WBV paradigm to the leg exercise protocol was no more effective in enhancing body functions/structures, activity, and participation than leg exercises alone in chronic stroke patients with mild to moderate motor impairments.

Establishing equivalence of a Chinese version of the stroke specific quality of life measure for stroke survivors

Introduction: The Stroke Specific Quality of Life Scale is a stroke-specific measure of health-related quality of life. However, there has been no Chinese (Hong Kong) version of the scale.Methods: A descriptive study was conducted to examine the reliability, validity and factor structure of the translated version (SSQOL-C) among stroke survivors. Participants completed SSQOL-C, and the Chinese versions of the Medical Outcomes Study Short-Form Health Survey (SF-36), Stroke Self-Efficacy Questionnaire (SSEQ-C) and Frenchay Activities Index (FAI). Thirty of these participants completed the same questionnaires after 4 weeks.Results: A total of 135 stroke survivors (mean age 58.90 ± 9.75) were recruited. SSQOL-C had good internal consistency with Cronbach’s alphas for each domain ranging from 0.63 to 0.90. Most domains had moderate to high correlations with similar dimensions of SF-36, SSEQ-C, FAI and Barthel ADL Index total scores (Spearman’s rho: 0.40–0.77, p < 0.01), suggesting acceptable convergent validity. Principal component analyses suggested an 11-factor model in contrast to the 12-factor model for the original scale with six new factors emerging and five original factors retained.Discussion: The results suggest SSQOL-C is a reliable and valid tool for measuring Chinese stroke survivors’ health-related quality of life. More studies are needed to confirm the 11-factor model of the scale.Implications for rehabilitationThe translated Chinese version of the Stroke Specific Quality of Life Scale is a reliable and valid tool for measuring Chinese stroke survivors’ health-related quality of life.An 11-factor model in contrast to the 12-factor model for the original scale with six new factors emerging and five original factors retained.

Elevated inflammatory markers predict mortality in long-term ischemic stroke-survivors: a population-based prospective study.

High levels of inflammatory markers shortly after an ischemic stroke are associated with a worse prognosis. Whether inflammatory markers predict long-term mortality in stroke-survivors is less clear. We examined whether a persisting inflammatory response (levels of inflammatory markers>1year after the stroke event) was associated with long-term mortality. We recruited participants from the Tromsø Study, Norway, in a nested case-control design. At baseline in 1997, white blood cell count (WBC), serum levels of fibrinogen, interleukin 6 (IL-6) and high sensitive C-reactive protein (hs-CRP) were analysed in 187 stroke-survivors, a median of 7.0years (range 1-43) after the first-ever ischemic stroke, and in 243 stroke-free subjects. Cox proportional hazard regression model was used to examine whether inflammatory markers predicted all-cause mortality in both groups from 1997 to 2013. During an average of 16years follow-up, 117 (62.5%) stroke-survivors and 107 (44.0%) stroke-free subjects deceased (p for differences 0.005). In stroke-survivors, fibrinogen and log IL-6 predicted all-cause mortality after adjustment for age, sex, BMI, smoking, Frenchay activity index, comorbidity and use of statins (HRs 1.26; 95% CI 1.05-1.51 and 2.02; 95% CI 1.12-3.64, respectively). In stroke-free subjects log hs-CRP predicted all-cause mortality after additionally accounting for levels of cholesterol, blood pressure and use of blood pressure lowering drugs (HR 1.95; 95% CI 1.26-2.99). Fibrinogen and IL-6 were independent predictors of mortality in long-term stroke-survivors, whereas elevated hs-CRP predicted mortality in stroke-free subjects. Mortality risk prediction in stroke-survivors differed from that of stroke-free subjects.

융합형 맞춤 작업치료 활동프로그램이 경도인지장애 노인의 심리 안정과 사회참여에 미치는 영향

본 연구는 경도인지장애 노인을 대상으로 융합형 맞춤 작업치료 활동프로그램을 실시하여, 경도인지장애 노인의 심리 안정 및 사회참여에 미치는 영향에 대해 알아보았다. 경도인지장애 노인 30명을 대상으로 무작위로 실험군과 대조군으로 각각 15명씩 나누어 6주간 주 2회 총 12회기를 3단계로 나누어 진행하였다. 중재 전과 후의 심리안정을 알아보기 위해, 한국판 노인우울척도(Korean Geriatric Depression Scale; KGDS)을 실시하였고, 사회참여를 비교하기 위해 Frenchay 일상생활활동 자기평가지수(Frenchay Activity Index; FAI)를 실시하였다. 중재 결과 실험군에서 중재 전과 후에 심리 안정, 사회참여는 증가를 보였으며, 대조군에서는 심리 안정에는 증가를 보였으나 사회참여에서는 증가를 보이지 않았다. 따라서 연구결과 융합형 맞춤 작업치료 활동프로그램은 경도인지장애를 가진 노인의 심리 안정 및 사회참여에 긍정적인 영향을 미친다는 사실을 알 수 있었다. This study aims to examine the effect of Convergence Tailed Occupational Therapy Activities Program (CTOTAP) which is customized to elderly people with mild cognitive impairment on their mental stability and social participation. A total of thirty elderly patients with mild cognitive impairment were randomly divided into a test group and a control group of 15 patients each, undergoing a total twelve sessions of the program (two sessions per week for six weeks) in three steps. In order to investigate the mental stability of the patients before and after the program, the Korean Geriatric Depression Scale (KGDS) was used while the Frenchay Activity Index (FAI) was used to explore the social participation of the patients. According to the findings of this study, there appeared to be an increase in the mental stability, social participation of the test group after the program. In addition, after the program there were differences between the test group and the control group in all of the mental stability and social participation. Therefore, the study has shown that the CTOTAP with customization has positive impact on the mental stability and social participation of patients with mild cognitive impairment.

Adaptation of Lawton Instrumental Activities of Daily Living (IADL) for Filipino Older Persons

The Lawton Instrumental Activities of Daily Living (IADL) is a tool that aids practitioners in assessing the functional status among older persons. The study aim to adapt the IADL for Philippine use, and determine its psychometric validity when used among Filipino older persons. The study utilized cross sectional design to validate the Lawton Instrumental Activities of Daily Living (IADL) for Filipino older persons. Seventeen (17) older persons were recruited from the Senior Citizen Registry of San Francisco Del Monte Quezon City, The original version of IADL was translated to Filipino by certified translator and back translated to English. The final version was pre-tested by cognitively intact older persons. Internal consistency and Exploratory Factor Analysis (EFA) of the Fil- IADL was computed by Cronbachs I±. The construct validity was studied by Exploratory Factor Analysis (EFA), Item convergent and discriminant validity was examined by Interclass Correlation Coefficient (ICC) for scores at baseline and at 2 weeks and the correlation of the IADL scale with Nottingham ADL Scale and Frenchay Activities Index (FAI) using Spearman correlation coefficient. A p value of less than 0.05 was considered statistically significant for all the analyses. The tool has an internal consistency of .80 which indicates that the tool is sufficiently reliable to use. Test re-test reliability was done at a mean of 14 days apart, The mean Fil- IADL mean scores were 5.47 (SD= 2.12) and 5.35 (SD= 2.17) for baseline and follow-up, respectively, with a mean change of 1.46 p=.163 >.05 and a correlation of .988 p=.000

Habitual and Low-Intensity Physical Activity in People with Multiple Sclerosis

People with Multiple Sclerosis (MS) undertake insufficient physical activity based on current guidelines. Recent work points to the benefits of increasing the amount of time spent in all non-sedentary physical activity. The current study sought to explore the potential benefits to community participation, as well as examine factors predictive, of engagement in ‘habitual’ and/or low-intensity physical activity. Seventy-four people with MS were compared to 67 healthy controls using the Frenchay Activities Index (FAI). Findings revealed differences in habitual activity level (p &lt; .001), and low-intensity physical activity (p &lt; .001), with people with MS having a lower level of engagement than healthy people. After controlling for the impact of MS on mobility, years since symptom onset, physical fatigue and reduced positive affect were the most significant predictors of engagement in ‘at least weekly’ low-intensity physical activity. Higher frequency of low-intensity physical activity was significantly associated with greater home, social and occupational participation (all p &lt; .05), and physical health status (p &lt; .01), but not mental health status (p = .964) in people with MS. Results suggest that improving habitual activity level and engagement in low-intensity physical activity may be of benefit for people with MS.

Long-Term Predictors of Social and Leisure Activity 10 Years after Stroke.

BackgroundRestrictions in social and leisure activity can have negative consequences for the health and well-being of stroke survivors. To support the growing number of people who are ageing with stroke, knowledge is needed about factors that influence such activity in a long-term perspective.AimTo identify long-term predictors of the frequency of social and leisure activities 10 years after stroke.Method145 stroke survivors in Sweden were followed-up at16 months and 10 years after a first-ever stroke. Data representing body functions, activities & participation, environmental factors and personal factors at 16 months after stroke, were used in multiple linear regression analyses to identify predictors of the activity frequency after 10 years, as assessed by the ‘Community, social and civic life’ sub-domain of the Frenchay Activities Index (FAI-CSC).ResultsAt the 10-year follow-up the frequency of social and leisure activities varied considerably among the participants, with FAI-CSC scores spanning the entire score range 0–9 (mean/median 4.9/5.0). Several factors at 16 months post stroke were independently related to the long-term activity frequency. The final regression model included four significant explanatory variables. Driving a car (B = 0.999), ability to walk a few hundred meters (B = 1.698) and extent of social network (B = 1.235) had a positive effect on activity frequency, whereas an age ≥ 75 years had a negative effect (B = -1.657). This model explained 36.9% of the variance in the FAI-CSC (p<0.001).ConclusionStroke survivors who drive a car, have the ability to walk a few hundred meters and have a wide social network at 16 months after a first-ever stroke are more likely to have a high frequency of social and leisure activities after 10 years, indicating that supporting outdoor mobility and social anchorage of stroke survivors during rehabilitation is important to counteract long-term inactivity.

Translation and Validation of a Chinese Version of the Stroke Self-Efficacy Questionnaire in Community-Dwelling Stroke Survivors

Background: Self-efficacy is a significant factor influencing stroke survivors’ participation in self-care and outcomes. The Stroke Self-Efficacy Questionnaire (SSEQ) is a stroke-specific measure of stroke survivors’ self-efficacy in performing daily functional activities and self-management. However, there has been no Chinese version of the questionnaire.Objective: The current study aims to examine the reliability and validity of a translated Chinese version of SSEQ (SSEQ-C).Methods: The English version of SSEQ has been translated into Chinese. A descriptive study was conducted. A convenience sample of 135 Chinese stroke survivors (mean age 58.9, SD 9.75) was recruited from three community centers and a stroke support group. Eligible participants completed the SSEQ-C, and the Chinese versions of General Self-Efficacy Scale (GSES), Frenchay Activities Index (FAI), and Stroke-Specific Quality of Life Scale (SSQOL). Thirty of the participants completed the questionnaires at baseline and 4 weeks afterwards.Results: SSEQ-C had a high internal consistency (Cronbach’s α 0.92). Test–retest reliability was satisfactory with the intraclass correlation coefficient of the total scale 0.52. Positive correlations were found between the total scores of SSEQ-C, GSES, FAI, and SSQOL (Spearman’s ρ: 0.48–0.68, p < 0.01), suggesting acceptable convergent validity. Principal component analysis suggested a two-factor model, namely “Live with new challenges” and “Activity and exercise engagement” in contrast to the single-factor model for the original questionnaire.Conclusion: The results suggest SSEQ-C is a reliable and valid tool for measuring Chinese community-dwelling stroke survivors’ self-efficacy in managing post-stroke condition. More studies are warranted to confirm the two-factor model of the questionnaire.