Lena Nordholm

Reliability of an interview approach to the Functional Independence Measure

Objective: To establish the reliability of an interview approach to the Functional Independence Measure (FIM). Design: Two raters were present at the same time during the interviews in the home and did independent ratings of the 18 FIM items. The interview procedure was repeated within a week by another two raters in the clinic. Subjects: Sixty-three stroke survivors (median age 63 years, range 18–71 years) were studied approximately two years after onset. Raters: Three occupational therapists and one nurse. Methods: Reliability was calculated as unweighted kappa statistics, percentage agreement (PA), and intraclass correlation coefficient (ICC). Results: Best agreement was found in the motor items of FIM. The kappa statistics showed good to excellent inter-rater values during the same interview except for the Social interaction item. The ICCs based on sum-score for motor (0.92) and social–cognitive items (0.75) respectively, were similar to those reported in the literature. The repeated interview by different raters showed less stable agreement according to kappa values for the items dealing with transfers, locomotion and social–cognition. Conclusions: FIM assessments showed high inter-rater agreement for the same interview setting (home as well as clinic), but the stability of the measure over time with a repeated interview by different raters was somewhat less satisfactory.

Self-assessment of well-being in a group of children with epilepsy

Epilepsy is common in childhood, the prevalence being about five per 1000 children. The purpose of this study was to assess well-being in children with controlled epilepsy (but did not include those with obvious neurodeficits such as mental retardation or cerebral palsy) and compare them with age-matched healthy children. The patient group comprised of 31 children, 12 boys and 19 girls, whereas the control population group consisted of 342 children, 176 boys and 166 girls who were all in good health. All children involved in the study were aged between 9-13 years. A questionnaire was distributed to the children to complete. It consisted of 39 bipolar adjectives and a visual analogue scale was employed. The results show that the group of children with controlled epilepsy did not differ significantly from the age-matched control group. There was no significant difference between the sexes except for the dimension of vitality, where the boys scored better than the girls. Thus the well-being of children with controlled epilepsy seems to be similar to that of children from a control population. The psychometric properties of the instrument were also assessed. An assessment of well-being in children with intractable epilepsy, using a similar approach, is in progress.

Assessment of walking, balance and sensorimotor performance of hemiparetic patients in the acute stage after stroke

The aims of the study were to assess the walking, balance and sensorimotor performance of hemiparetic patients in the acute stage (3-8 weeks) after stroke, and to determine the extent of correlation between these variables. Twenty-eight patients aged 55.0±9.3 years (mean±SD) with residual hemiparesis due to a first stroke were assessed. The average walking velocity for the 16 patients who were able to complete the 10-m walking test was 0.26 m/s, and they rated their difficulty in performing this test as ‘moderate’. The mean score (±SD) on the Berg Balance Scale was 23±16 and on the Fugl-Meyer Sensorimotor Assessment 153±36. Patients requiring a greater number of steps while walking 10 m tended to have lower extremity motor function and decreased balance function. Furthermore, patients with poorer balance had to exert themselves more when walking (rs = -0.73, P <0.01). The Berg Balance Scale and the ‘Balance’ subsection of the Fugl-Meyer Sensorimotor Assessment correlated significantly (r = 0.77, P <0.001)...

Health-related quality of life in children diagnosed with asthma, diabetes, juvenile chronic arthritis or short stature: Health-related quality of life in children

Aim: 1) To assess the reliability and validity of the Swedish version of the Child Health Questionnaire (CHQ), 2) to determine the correlation between childrens and parents’ responses to the CHQ, and 3) to describe and compare responses to the CHQ of four diagnostic groups. Methods: A total of 199 Swedish children aged 9–16 with diagnoses of asthma (n=53), diabetes (n=48), short stature (n=51) and juvenile chronic arthritis (JCA, n=47) and their parents answered the CHQ and relevant validation instruments at a clinic check‐up. Coefficient alphas were determined for all dimensions of the instrument, and all but four had acceptable to very good reliability (0.75–0.94). Results: Concerning construct validity, the CHQ correlated significantly with appropriate dimensions of the validation instruments. In general, there were significant correlations between the childrens and parents’ responses. Comparisons between the diagnostic groups showed several significant differences. The short stature group had the highest quality of life and the JCA group the lowest. There were no sex differences, but children who had not reached puberty scored better on the dimensions of mental health and self‐esteem.