The diverse constructs use of activities of daily living measures in stroke randomized controlled trials in the years 2005-2009

Objective: To explore construct(s) (ability, capability, actual performance, and/or perceived difficulty) of activities of daily living measures that have been used in randomized controlled trials. Methods: Three databases (Medline, CINAHL, and OTSeeker) were searched. A questionnaire was sent to the author of each eligible study requesting information about the activities of daily living construct(s) that were adopted in his/her study. Results: A total of 106 studies, which altogether used 17 different activities of daily living measures, were found. Among these, only 12 studies specified in the paper the activities of daily living construct assessed; 7 studies assessed "ability" and 5 assessed "actual performance". Only 20% of the randomized controlled trials authors reported the mode of administration in the paper. Authors of 34 studies replied to our questionnaire. The most commonly used activities of daily living measures (i.e. The Barthel Index (either the 0-20 or 0-100 scoring version) and the Functional Independence Measure) were employed for assessing various constructs of activities of daily living, with inconsistency between the studies. Conclusion: In stroke randomized controlled trials that measured activities of daily living as an outcome, the measures were used for assessing various construct(s) of activities of daily living (including ability, capability, actual performance, and/or perceived difficulty). This could hamper data interpretation, meta-analysis, and the translation of evidence into clinical practice.