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The FAC assesses functional ambulation in patients undergoing physical therapy.
1
1 minutes
Adult
18 - 64
yearsInitially reviewed by the Rehabilitation Measures Team; Updated with references from the TBI population by Katie Hays, PT, DPT and the TBI EDGE task force of the Neurology Section of the APTA in 2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: ANPT Outcome Measures Recommendations (EDGE)
Abbreviations:
HR
Highly Recommend
R
Recommend
LS / UR
Reasonable to use, but limited study in target group / Unable to Recommend
NR
Not Recommended
Recommendations for use based on acuity level of the patient:
Acute
(CVA < 2 months post)
(SCI < 1 month post)
(Vestibular < 6 weeks post)
Subacute
(CVA 2 to 6 months)
(SCI 3 to 6 months)
Chronic
(> 6 months)
StrokEDGE
R
UR
UR
Recommendations based on level of care in which the assessment is taken:
Acute Care
Inpatient Rehabilitation
Skilled Nursing Facility
Outpatient
Rehabilitation
Home Health
StrokEDGE
UR
R
UR
UR
UR
TBI EDGE
LS
LS
LS
LS
LS
Recommendations for use based on ambulatory status after brain injury:
Completely Independent
Mildly dependant
Moderately Dependant
Severely Dependant
TBI EDGE
NR
LS
LS
NR
Recommendations for entry-level physical therapy education and use in research:
Students should learn to administer this tool? (Y/N)
Students should be exposed to tool? (Y/N)
Appropriate for use in intervention research studies? (Y/N)
Is additional research warranted for this tool (Y/N)
StrokEDGE
No
No
No
Not reported
TBI EDGE
No
Yes
No
Not reported
Tested primarily in stroke population:
(Kollen et al, 2006): FAC scores depend on the timing of comfortable walking speed measurements after stroke
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!
Acute Stroke: (Mehrholz et al, 2007; n = 55; mean age = 62.8 (10.2) years; average time since stroke= 30.6 (15.5) days (assessed 30 to 60 days after stroke); German sample)
Acute Stoke: (Kollen et al, 2006; n = 73; mean age = 64.8 (10.5) years; mean days from CVA to assessment 8.2 (2.8) days; mean Mini-Mental State Examination score = 26.7 (2.3) points; FAC Scores 3-5 used in analysis)
Functional Ambulation Categories (FAC) Scores
Value at the following week after stroke:
FAC Score
Measurement
4
5
6
7
8
9
10
12
14
16
18
20
26
3
Walking speed (m/s)
0.45
0.43
0.37
0.45
0.33
0.39
0.38
0.35
0.33
0.29
0.30
0.30
0.19
4
Walking speed (m/s)
0.73
0.90
0.80
0.63
0.65
0.64
0.58
0.57
0.50
0.50
0.49
0.48
0.48
5
Walking speed (m/s)
1.08
0.92
1.04
1.04
1.06
1.02
1.11
1.07
1.06
1.04
1.00
1.02
0.92
Acute Stroke: (Mehrholz et al, 2007)
FAC Normative Data:
Measure
Scale
basline
2-weeks
4-weeks
6-months
FAC
0 - 5
0.44 (0.69)
1.22 (1.32)
1.98 (1.50)
2.79 (2.12)
RMI
0 - 14
2.51 (1.62)
4.04 (2.88)
5.76 (3.93)
7.38 (5.01)
6MWT
meters
15.9 (34.3)
50.9 (81.1)
83.9 (107.8)
112.3 (143.9)
Walking velocity
(m/s)
0.07 (0.14)
0.19 (0.28
0.33 (0.46)
0.38 (0.51)
Step length
meters
0.09 (0.13)
0.18 (0.19)
0.27 (0.20)
0.28 (0.26)
mean (SD)
Acute Stroke: (Mehrholz et al, 2007)
Acute Stroke: (Mehrholz et al, 2007)
Acute Stroke: (Mehrholz et al, 2007):
Values are Spearman p all with (p< .001)
Parameter
FAC Scores at Baseline
FAC Scores After 2 Weeks
FAC Scores After 4 Weeks
FAC Scores at 6-Month Follow-Up
RMI
0.686
0.787
0.825
0.893
6MWT
0.949
0.937
0.931
0.906
Walking velocity
0.952
0.939
0.902
0.901
Step length
0.952
0.932
0.896
0.877
Acute stroke: (Kollen et al, 2006):
Stroke: (Salter et al, 2008, overall review of measure)
Acute Stroke: (Mehrholz et al, 2007)
FAC scores changed significantly between:
Stroke: (Salter et al, 2008)
(Kollen et al, 2006)
Stroke and Multiple Sclerosis: (Holden et al, 1984; n=61(n=24 with MS, mean age= 39(9.8) years, n=37 with hemiparesis, mean age=51(17) years):
Collen, F. M., Wade, D. T., et al. (1990). "Mobility after stroke: reliability of measures of impairment and disability." Int Disabil Stud 12(1): 6-9. Find it on PubMed
Holden, M. K., Gill, K. M., et al. (1986). "Gait assessment for neurologically impaired patients. Standards for outcome assessment." Phys Ther 66(10): 1530-1539. Find it on PubMed
Kollen, B., Kwakkel, G., et al. (2006). "Time dependency of walking classification in stroke." Phys Ther 86(5): 618-625. Find it on PubMed
Martin, B. and Cameron, M. (1996). "Evaluation of walking speed and functional ambulation categories in geriatric day hospital patients." Clinical rehabilitation 10(1): 44.
Mehrholz, J., Wagner, K., et al. (2007). "Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke." Arch Phys Med Rehabil 88(17908575): 1314-1319. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.