• Generic instrument that can be used with persons with or without disability
  • Developed to measure independence in basic activities of daily living (ADLs)
  • Can be use in people with or without disabilities, as well as in both adults and children
  • The majority of items measure ADLs and others measure body function (bladder/bowel emptying and incontinence, chewing/swallowing food and liquids, verbalizing telephone messages)
  • Items are divided into 6 sub-dimensions:

1) Mobility
2) Emergency Communication
3) Dressing
4) Elimination
5) Bathing/Hygiene
6) Eating.

Clinical Considerations

  • The K-B Scale divides each activity into its essential components to get a measure of ADL performance. This is advantageous over other known ADL scales as it makes it possible to detect problematic items within activities and thus helps to better identify rehabilitation treatment.
  • The authors suggest using the scale as a method to generate discussion about goals they wish to achieve.
  • The scale was not designed specifically for people with SCI; therefore, items included in the scale may not be important for SCI populations.

ICF Domain

Activity ▶ Self-Care

Administration

  • Clinician-administered interview
  • Measures degree of patient independence
  • Administration of the scale takes from 1-3 hours.

Number of Items

170

Equipment

Items typically used in basic activities of daily living (ex. toilet, bed, etc.)

Scoring

  • Task weights of 1, 2, or 3 are assigned to each task.
  • In developing the weights, four factors were considered, including: importance to health, difficulty for non-disabled persons, time required to perform the task, and the burden of care-giving.
  • Items are summed (each task is multiplied by its weight)
  • Overall independence scores range from 0 to 313 (0%-100%).

Languages

English

Training Required

None

Availability

Currently unavailable

Measurement Property Summary

Number of studies reporting psychometric properties: 3

Interpretability

  • Higher scores indicate greater independence.
  • No normative data has been established for the SCI population at this time.
  • MCID: not established in SCI population
  • SEM: not established in SCI population
  • MDC: not established in SCI population

Reliability

No values were reported for the reliability of the Klein-Bell Scale for the SCI population.

Validity – Low to High

Number of studies reporting validity data: 3

  • High correlation of the K-B Scale with the:
    • Jebsen-Taylor total score: Spearman’s r = -0.635
    • Jebsen-Taylor Test- dressing subscale: Spearman’s r = -0.69

(Lynch & Bridle 1989; n=18; mean age: 52 (age range 26-70) years)

  • High correlation of the K-B Scale with the ASIA Upper Extremity Motor Score (UEMS): Correlation = 0.63

(Dahlgren et al. 2007; n=55; 43 males, 12 females; mean age: 39; mean time since injury: 5.5 years)

  • Moderate correlation of the K-B Scale with the:
    • Jebsen Taylor Test – Bathing/Hygiene subscale: Spearman’s r = -0.57
    • Jebsen Taylor Test – Eating subscale: Spearman’s r = -0.45

(Lynch & Bridle 1989; n=18; mean age: 52 (age range 26-70) years)

  • Low correlation with the COPM Performance: r = 0.07

(Samuelsson et al. 2004; n=56; 44 males; mean age: 48.9 years; mean time since injury: 13.9 years)

Responsiveness

No values were reported for the responsiveness of the K-B Scale for the SCI population.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the K-B Scale for the SCI population.

Reviewer

Dr. Carlos L. Cano-Herrera, Tyra Chu

Date Last Updated

December 31, 2024

Dahlgren A, Karlsson A-K, Lundgren Nilsson A, Friden J, Claesson L. Activity performance and upper extremity function in cervical spinal cord injury patients according to the Klein-Bell ADL Scale. Spinal Cord 2007; 45: 475-484.
http://www.ncbi.nlm.nih.gov/pubmed/17117173

Lynch KB, Bridle MJ. Validity of the Jebsen-Taylor Hand Function Test in Predicting Activities of Daily Living. The Occupational Therapy Journal of Research 1989; Volume 9, Number 5: 316-18.
http://scholar.google.ca/scholar?q=Validity+of+the+Jebsen-Taylor+Hand+Function+Test+in+Predicting+Activities+of+Daily+Living.&btnG=&hl=en&as_sdt=0%2C5

Samuelsson KA, Tropp H, Gerdle B. Shoulder pain and its consequences in paraplegic spinal cord-injured, wheelchair users. Spinal Cord. 2004 Jan;42(1):41-6. https://pubmed.ncbi.nlm.nih.gov/14713943/

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