• Assesses frequency of performing Instrumental Activities of Daily Living (IADL)
  • Includes items that reflect the patient’s behavior in the areas of domestic chores, leisure/work, and outdoor activities
  • A revised 13-item FAI has recently been assessed among SCI patients. The following summary therefore focuses on the revised FAI.

Clinical Considerations

  • The FAI does not assess whether patients can perform or how well they perform IADL.
  • The 13 item revised FAI was developed specifically for use with SCI patients.
  • The revised 13-item scale is brief, quick to complete, and reflects the everyday activities of daily living.

ICF Domain

Activity ▶ Self-Care

Administration

  • Self-administered or interview format using a 2 and 3 point ordinal scale
  • Administration usually takes between 5-15 minutes.

Number of Items

13 items

Equipment

None

Scoring

  • According to Hsieh et al. (2007), the revised FAI includes 13 items (two items in the original FAI, reading books and walking outside or going outside did not fit the Rasch model and were therefore taken out).
  • 4 items (washing up, washing clothes, driving a car/bus travel, and gainful work) are scored on a 2 point scale, and the remaining 9 items are scored on a 3-point scale. The response categories are 0 = never, 1 = occasionally or more, and 2 = most days.
  • The total item summary score ranges from 0 to 22.

Languages

English

Training Required

No formal training required. However, relevant clinical experience is beneficial.

Availability

The FAI worksheet can be found here.

Measurement Property Summary

Number of studies reporting psychometric properties: 2

Interpretability

  • Higher scores indicate greater frequency of doing IADL.
  • The raw scores of the 13-item FAI can be transformed to interval scores thereby enabling clinicians and researchers to quantify and monitor IADL function in SCI patients.
  • No cut-points or normative data for the SCI population have been established
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Study Details sheet)
  • MCID: not established in SCI population
  • SEM:
Items SE Logit:
1. Washing up 0.17
2. Preparing main meals 0.13
3. Washing clothes 0.17
4. Driving car/bus travel 0.17
5. Light housework 0.11
6. Heavy housework 0.12
7. Local shopping 0.11
8. Social occasions 0.13
9. Actively pursuing hobby 0.12
10. Gainful work 0.16
11. Travel outings/car rides 0.15
12. Gardening 0.15
13. Household/car maintenance 0.15

(Hsieh et al. 2007, n=233; 193 males; mean (SD) age: 41.1 (12.6) years, 33 Complete, 57 Incomplete tetraplegia; 151 Complete, 48 Incomplete paraplegia)

  • MDC: not established in SCI population

Reliability – High

Number of studies reporting reliability data: 2

  • High internal consistency: α > 0.90

(Chern et al. 2013; n=2339; 1454 males; mean (SD) age: 45 (18.5) years; traumatic limb injuries)

  • Rasch analysis reliability coefficient was reported to be 0.78.

(Hsieh et al. 2007, n=233; 193 males; mean (SD) age: 41.1 (12.6) years, 33 Complete, 57 Incomplete tetraplegia; 151 Complete, 48 Incomplete paraplegia)

Validity – Low to Moderate

  • Low to Moderate correlation between the R-FAI administered at 3, 6, and 12 months after injury and the 4 domains of the WHOQOL-BREF administered at 12 months after injury

(Chern et al. 2013; n=2339; 1454 males; mean (SD) age: 45 (18.5) years; traumatic limb injuries)

  • The Frenchay Activities Index was validated as a unidimensional construct through revision of the scale after Rasch analysis.

(Hsieh et al. 2007, n=233; 193 males; mean (SD) age: 41.1 (12.6) years, 33 Complete, 57 Incomplete tetraplegia; 151 Complete, 48 Incomplete paraplegia)

Responsiveness

Number of studies reporting responsiveness data: 1

Effect Size

  • 3 months post-injury: 0.10
  • 6 months post-injury: 0.35
  • 12 months post-injury: 0.15

(Chern et al. 2013; n=2339; 1454 males; mean (SD) age: 45 (18.5) years; traumatic limb injuries)

Floor/Ceiling Effect

The FAI exhibited a slight floor effect (9.9% of participants scored the lowest possible score) and no ceiling effect.

(Hsieh et al. 2007)

Reviewers

Dr. Carlos L. Cano-Herrera, Tyra Chu

Date Last Updated

December 31, 2024

Holbrook M, Skilbeck CE. An Activities Index for use with stroke patients. Age and Ageing 1983; 12: 166-170.
http://www.ncbi.nlm.nih.gov/pubmed/6869117

Hsieh CL, Jang Y, Yu TY, Wang WC, Sheu CF, Wang YH. A Rasch analysis of the Frenchay Activities Index in patients with spinal cord injury. Spine 2007; 32: 437-442.
http://www.ncbi.nlm.nih.gov/pubmed/17304134

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