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RehabMeasures Instrument

Functional Behavior Profile

Purpose

The FBP is a clinical assessment used to guide placement/discharge decisions following stroke.

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Instrument Details

Acronym FBP

Area of Assessment

Activities of Daily Living
Cognition
Executive Functioning
Functional Mobility
Life Participation
Patient Satisfaction
Reasoning/Problem Solving
Social Relationships

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil

Cost

Free

Diagnosis/Conditions

  • Multiple Sclerosis
  • Stroke Recovery

Key Descriptions

  • FBP can also be used in an interview format with a caregiver at home or in an outpatient setting which typically takes approximately 20 minutes to complete.
  • Item responses range from 0 to 4, with higher scores indicating better performance (maximum score 108).
  • The scores are on a continuum that ranges from:
    4 = Always
    3 = Usually
    2 = Sometimes
    1 = Rarely
    0 = Never
  • Scores of "Sometimes" or "Rarely" are designed to facilitate dialogue between the patient and caregiver (or clinician).
  • The dialogue should provide the caregiver with greater insight into how productive behaviors can be encouraged and facilitated.

Number of Items

27

Time to Administer

10-20 minutes

Required Training

No Training

Age Ranges

Elderly Adult

65 +

years

ICF Domain

Environment

Measurement Domain

Activities of Daily Living
Cognition

Considerations

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Stroke

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Cut-Off Scores

Acute Stroke: (Baum et al, 2000; n = 45; mean age = 68.33 (12.6) years; within 8 days of stroke onset)

  • Scores of 84 or lower were five times more likely to need supervision after discharge than individuals
    with scores of 85 or more
  • A cut-off score of 84 had a sensitivity of 0.75 and specificity of 0.68

Normative Data

Acute Stroke: (Baum et al, 2000)

FBP & Other Clinical Measure Norms:

 

 

 

Scale

Possible Range

Mean (SD)

Actual Range

FBP Total

0 to 108

82.8 (17.6)

23 to 108

FBP Task Performance

0 to 36

27.0 (5.7)

12 to 36

FBP Social
Interaction

0 to 24

19.9 (4.1)

6 to 24

FBP Problem
Solving

0 to 48

36.0 (9.1)

5 to 48

NIHSS

0 to 36

9.87 (4.5)

3 to 24

FIM Motor

13 to 91

68.4 (13.1)

40 to 88

FIM Cognitive

5 to 35

26.6 (5.6)

15 to 35

Internal Consistency

Acute Stroke: (Baum et al, 2000)

  • Excellent: FBP total (Cronbach's alpha = 0.86)
  • Excellent: Task Performance (Cronbach's alpha = 0.82)
  • Excellent: Social Interaction (Cronbach's alpha = 0.86)
  • Adequate: Problem Solving (Cronbach's alpha = 0.74)

Content Validity

  • based on the Comprehensive Occupational Therapy Evaluation (COTE

  • developed with input from families

  • developed in a two stage process: 

    • stage 1 included input from families while the second families participating in support groups completed a questionnaire and provided feedback

    • Stage 2: a 51 item questionnaire was created and administered to 106 caregivers. From these items, 27 were retained for the final measure.

Alzheimer's Disease and Progressive Dementia

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Internal Consistency

Dementia: (Burgener et al, 2005; n = 96; mean age = 77.3 (7.8) years; mean MMSE scores = 21.8 (4.3) points)

  • Excellent: FBP total (Cronbach's alpha = 0.94)
  • Excellent: FBP subscale (Cronbach's alpha's ranged from 0.83 to 0.85)

 

Alzheimer's: (Baum et al, 1993; n = 106; mean age = 71.5 (range = 53.8 to 85.41) years)

  • Excellent: Performance of Tasks (alpha = 0.961
  • Excellent: Socialization (alpha = 0.939)
  • Excellent: Problem Solving (alpha = 0.948)

Criterion Validity (Predictive/Concurrent)

Alzheimer's: (Baum et al, 1993)

Concurrent Validity:

  • Excellent: Zarit Memory And Behavior Checklist (r = -0.83)
  • Excellent: Blesses Dementia Scale (r = -0.83)
  • Excellent: The Katz ADL Scale (r = -0.85

Content Validity

  • based on the Comprehensive Occupational Therapy Evaluation (COTE

  • developed with input from families

  • developed in a two stage process: 

    • stage 1 included input from families while the second families participating in support groups completed a questionnaire and provided feedback

    • Stage 2: a 51 item questionnaire was created and administered to 106 caregivers. From these items, 27 were retained for the final measure.

Multiple Sclerosis

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Construct Validity

(Goverover et al, 2005; n = 74; mean age = 44.7 (8.7) years; mean BDI score = 10.5 (7.4); Ambulation Index Score = 3.1 (2.2) points)

Correlations Between Objective and Subjective Measures of Functional Performance for Subjects:

 

 

 

 

Measure

EFPT Total Scor

FBP Self

FBP Proxy

FAMS

Hand washing

-0.01

0.11

0.09

-0.04

Simple cooking

0.70~

0.02

-0.18

0.01

Using the phone

0.44~

-0.01

0.04

-0.02

Complex cooking

0.65~

-0.10

0.09

-0.09

Taking medication

0.38~

-0.09

-0.14

-0.05

Paying bill

0.42~

-0.18

-0.26

0.04

*p < 0.05
~p < 0.01

 

 

 

 

FAMS = Functional Assessment of Multiple Sclerosis
EFPT = The Executive Function Performance Test

 

 

 

 

Content Validity

  • based on the Comprehensive Occupational Therapy Evaluation (COTE
  • developed with input from families
  • developed in a two stage process:
    • stage 1 included input from families while the second families participating in support groups completed a questionnaire and provided feedback
    • Stage 2: a 51 item questionnaire was created and administered to 106 caregivers. From these items, 27 were retained for the final measure.

Bibliography

Baum, C., Edwards, D. F., et al. (1993). "Identification and measurement of productive behaviors in senile dementia of the Alzheimer type." Gerontologist 33(3): 403-408. Find it on PubMed

Baum, M. C. and Edwards, D. F. (2000). "Documenting productive behaviors. Using the functional behavior profile to plan discharge following stroke." J Gerontol Nurs 26(4): 34-40; quiz 41-33. Find it on PubMed

Burgener, S., Twigg, P., et al. (2005). "Measuring psychological well-being in cognitively impaired persons." Dementia 4(4): 463.

Goverover, Y., Kalmar, J., et al. (2005). "The relation between subjective and objective measures of everyday life activities in persons with multiple sclerosis." Arch Phys Med Rehabil 86(12): 2303-2308. Find it on PubMed

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