Assessment of Life Habits

Older Adults:

(Lemmens et al, 2006; n = 85 adults with functional limitations and n = 40 healthy adults; sample included various chronic illnesses; dutch sample, Older Adults)

Life-H Standard Error of Measurement:

SEM = standard error of measurement

Older Adults with disabilities:

(Noreau et al, 2004; n=40; mean age = 76.5(8.6) years; calculated from standard deviation and ICC values given in Table 4)

Older Adults with Disabilities:

(Noreau et al, 2004; n = 40; mean age = 76.5 (8.6) years; calculated from standard deviation and ICC values given in Table 4, Older Adults with Disabilities)

Older Adults:

(Desrosiers et al, 2009; n = 350 randomly recruited community-dwelling elderly adults, Older Adults)

Life-H Norms by Age Group:

Elderly People with Disabilities:

(Noreau et al, 2004; test-retest study n = 40; mean age = 76.5 (8.6); gender = female 29 (72.5); interval between 2 time frames = 5-10 days, Elderly People with Disabilities)

• Total Score: ICC = 0.95 (Excellent)
• Daily Activities Subscore: ICC = 0.96 (Excellent)
• Social Roles Subscore: ICC = 0.76 (Adequate)

Older Adults with Disabilities:

(Poulin & Desrosiers, 2009; n = 30; mean age 79.4 (7.1); 56.7% female; having significant functional disabilities according to SMAF; recruitment from inpatient rehab unit or short-term geriatric care unit of HSSC-UIGS (Canadian sample) in last 5 years, Older Adults with Disabilities)

• Excellent test-retest reliability for total score (ICC = 0.88)
• Categorical test-retest reliability:
  • Excellent for communication (ICC = 0.88)
  • Excellent for fitness (ICC = 0.76)
  • Excellent for housing (ICC = 0.75)
  • Adequate for personal care (0.73)
  • Adequate for nutrition (ICC = 0.69)
  • Adequate for mobility (ICC = 0.69)
  • Excellent for daily activities (ICC = 0.84)
  • Excellent for leisure (ICC = 0.87)
  • Excellent for interpersonal relationships (ICC = 0.87)
  • Excellent for responsibilities (ICC = 0.80)
  • Adequate for community life (ICC = 0.65)
  • Excellent for social roles (ICC = 0.85)

Older Adults with Stroke :

(Lemmens, et al, 2007; n = 35; mean age = 59 (7.7); gender = male 49%, Older Adults with Stroke)

• The Dutch LIFE-H showed excellent test-retest reliability (ICC = 0.80) for the total score
• ICC values for subscale scores varied: ranging from 0.21 for social relationships to 0.88 for personal care

Elderly with Physical Disabilities:

(Noreau et al, 2004; n = 44; mean age = 80.0(7.7) years, Elderly with Physical Disabilities)

• Excellent interrater reliability (ICC = 0.89)

Children and Adults with impairments :

(Noreau et al, 2002; Review of studies regarding social participation with various impairments in adults and children, Children and Adults with Impairments)

Between Life-H and CHART

• N = 482 Adults SCI
• Spearman’s rho
• Physical independence

o Excellent 0.76

• Occupation

o Adequate 0.36

• Mobility

o Adequate 0.33

• Social integration

o Poor 0.14

Between Life-H and CIQ

• N = 30 adults TBI
• Home integration

o Adequate 0.56

• Social integration

o Adequate 0.54

• Productive activities

o Excellent 0.75

Older Adults with Functional Limitations:

Convergent Validity

(Desrosiers et al., 2004; n = 87; mean age = 78.0 (8.2), Older Adults with Functional Limitations)

Adequate correlations found between LIFE-H and the Functional Autonomy Measurement System (SMAF) total scores (0.70, p < 0.0001)

Discriminant Validity

(Desrosiers et al., 2004; n = 87; mean age = 78.0 (8.2), Older Adults with Functional Limitations)

• Participants living in private nursing homes obtained higher scores, followed by those living at home and finally by those living in long-term care units. These variations in scores between the living environments, which are supported by differences in disability levels (SMAF scores), indicate a good level of discriminant validity for the nLIFE-H, particularly in the daily activities.

Children and Adults with impairments:

(Noreau et al, 2002; Review of studies regarding social participation with various impairments in adults and children; n = 24 children & 25 adults with SCI, Children and Adults with Impairments)

• Short form total score
  • Adequate for children (ICC = 0.67)
  • Excellent for adults (ICC = 0.83)
• Long form total score
  • Excellent for children (ICC = 0.80)
  • Excellent for adults (ICC = 0.89)

Children with Cerebal Palsy:

(Sakzewski et al, 2007; Review of participation measures for children with CP aged 5 to 13; n = 48, Children with CP)

• Total Score Short Form
  • Poor ICC = 0.67
• Total Score Long Form
  • Adequate ICC= 0.73

Children (Cerebral palsy, myelomeningocoele, sensory-motor neuropathy, traumatic brain injury, developmental delay):

(Noreau et al, 2007; n=91 parents, Children with Disabilities)

(Sakzewski et al, 2007; Review of participation measures for children with CP aged 5 to 13; n = 48, Children with CP)Children with Cerebral Palsy:

• Intrarater ICC
  • Daily Activities 0.82-0.96 Excellent
  • Social Roles > 0.90 Excellent
  • Interpersonal relationships 0.64 Adequate
• Interrater ICC
  • 0.70-0.91 Adequate to Excellent
  • Interpersonal relationships 0.62 Adequate

Children and Adults with Impairments:

(Noreau et al, 2002; Review of studies regarding social participation with various impairments in adults and children; n= 24 children & 25 adults with SCI, Children and Adults with Impairments)

• Short form Cronbach alpha ≥ 0.82
  • Excellent
• Long form Cronbach alpha ≥ 0.90
  • Excellent

Children with Cerebral Palsy:

(Sakzewski et al, 2007; Review of participation measures for children with CP aged 5 to 13; n = 48, Children with CP)

• Daily Activities
  • Excellent alpha 0.97
• Social Roles
  • Excellent alpha 0.90
• Categories
  • Moderate to Excellent alpha 0.73-0.90
• Interpersonal relationships
  • Poor alpha 0.40

Children with Cerebral Palsy:

(Sakzewski et al, 2007; Review of participation measures for children with CP aged 5 to 13; n = 48, Children with CP)

• Domains of PEDI, WeeFIM, Life-H
  • Self-care r = 0.83-0.94
  • Education/recreation: 0.79-0.91

Children and Adults with impairments :

(Noreau et al, 2002; Review of studies regarding social participation with various impairments in adults and children, Children and Adults with Impairments)

Between Life-H and CHART

• N = 482 Adults SCI
• Spearman’s rho
• Physical independence

o Excellent 0.76

• Occupation

o Adequate 0.36

• Mobility

o Adequate 0.33

• Social integration

o Poor 0.14

Between Life-H and CIQ

• N = 30 adults TBI
• Home integration

o Adequate 0.56

• Social integration

o Adequate 0.54

• Productive activities

o Excellent 0.75

Children with Disabilities (Cerebral palsy, myelomeningocoele, sensory-motor neuropathy, traumatic brain injury, developmental delay):

(Noreau et al, 2007; n = 91 parents, Children with Disabilities)

Covergent validity:

• Pediatric Evaluation of Disability Inventory (PEDI) Self-care and Mobility dimensions (Functional Skills scale) were strongly associated with LIFE-H Personal care and Housing dimensions (0.79 <r < 0.88) and PEDI Social function was strongly associated with LIFE-H categories, Communication and Responsibility ( r = 0.80-0.81)
• High correlations between LIFE-H Housing and Personal care with Functional Independence Measure for Children (WeeFIM) Self-care, r = 0.90-0.94; LIFE-H and WeeFIM communication, r = 0.89)

Divergent validity:

• Associations of all PEDI dimensions with some LIFE-H dimensions were weaker (Interpersonal relationships and Community life), supporting a distinctiveness between the two constructs: activities of daily living (ADL) and social roles

WeeFIM cognitive dimensions (communication and social cognition) showed a lower association with LIFE-H motor dimensions (i.e. mobility, r = 0.43-0.49 respectively).

Children with Disabilities:

Convergent Validity

(Noreau, 2007; n = 94 parents of children with disabilities; children: 36 males, 58 females; mean age 8y 10mo (2y 6),Children with Disabilities)

Associations between LIFE-H for children and PEDI (Pediatric Evaluation of Disability Inventory) as measured by Pearson’s correlation coefficient; n = 94

Evaluated by an extensive development process involving consultation with 12 international experts including researchers, services providers, and consumer representatives. Experts concluded that the LIFE-H items covered most of a person's life habits (ADL and social roles) and it could be used to determine the appearance of handicap situations. The instrument was refined based on clinical evaluation (Fougeyrollas et al, 1998)

LIFE-H for children (Cerebral palsy, myelomeningocoele, sensory-motor neuropathy, traumatic brain injury, developmental delay) :

(Noreau et al, 2007, Children with Disabilities)

• Content validity was established with the help of an expert panel (n = 29), comprising parents of children with functional limitations (n = 11), experienced pediatric clinicians (n = 15), and researchers (n = 3)
• The panel reviewed the content of the LIFE-H for its overall relevance for children from 5 to 13 years old
• They assessed the comprehensiveness and clarity of the wording of the measure

Acording to Tse et al (2012) the LIFE-H has content validity because it is based on the Disability Creation Process Model and was developed and reviewed by experts

Acording to Tse et al (2012) the LIFE-H has face validity because it is based on the Disability Creation Process Model and was developed and reviewed by experts

Children With Congenital Hemiplegia:

(Sakzewski et al, 2011; n = 64; mean age = 10.2 (2.7) years, Children with Congenital Hemiplegia)

• Ceiling effects were observed with LIFE-H categories including community life and interpersonal relationships

Older Adults with Stroke :

(Lemmens, et al, 2007; n = 35; mean age = 59 (7.7); gender = male 49%, Older Adults with Stroke)

• The Dutch LIFE-H showed excellent test-retest reliability (ICC = 0.80) for the total score
• ICC values for subscale scores varied: ranging from 0.21 for social relationships to 0.88 for personal care

Stroke:

(Desrosiers et al, 2003; n = 132; mean age = 69.9 (13.5); mean rehab stay = 79.0 (45.5) days; 2-week (T3) and 6 month (T4) post rehabilitation, Acute Stroke)

SMAF = syste`me de mesure de l’autonomie fonctionnelle
FIM = functional independence measure
* Pearson correlation coefficients: at time 3, all significant at the 0.001 level

(Desrosiers et al, 2005; n_stroke= 46, n_healthy= 46; mean age_stroke= 72.5 (11.5) years, mean age _healthy= 73.0 (11.4)years; time post stroke = 4-6 years; French and English sample, Stroke)

Stroke :

Spouses of Individuals with First Time Stroke:

(Rochette et al, 2007; n = 54 spouses; time periods of assessment = before stroke (retrospectively), at 2 weeks, and at 6 months post stroke, Spouses of Individuals with First Time Stroke)

• At 2 weeks (T1): moderate effect size for LIFE-H total score (0.53), small for ADL sub core (0.0) and large for social roles subscore (0.90)
• At 6 months post stroke (T2): small effect side for LIFE H Total score (0.38), ADL subscore (0.13), and moderate for Social role subscore (0.76)
• Changes in participation were larger for personal relationships (T1 = 0.67; T2 = 0.83),, employment (T1 = 0.68; T2 = 0.63), and recreation ( T1 = 1.16; T2 = 0.93) , showing moderate to large effect sizes

Stroke:

(Rochette et al, 2007 (n = 35; mean age = 72.3 (10.5); gender = male 42.9%; time periods of assessment = before stroke (retrospectively), at 2 weeks, at 3 months, and at 6 months post stroke, Mild Stroke)

• At 2 weeks: Large effect size for LIFE-H total score (1.21), ADL (1.15) and Social Roles (1.24) subscores
• 6 months post stroke and 2 weeks post stroke: moderate effect sizes for LIFE-H total score (0.60), ADL sub sore (0.64) and Social role sub score (0.56)
• 6 months post-stroke and before the stroke: moderate effect sizes for LIFE-H total score (0.62), ADL sub score (0.58) and Social role sub score (0.70)

(Rochette et al, 2007; n = 35; mean age = 72.3(10.5) years; time post stroke = 2-3 weeks (T1), 3 months (T2), and 6 months (T3); severity > 8.5 on Canadian Neurological Scale; French and English sample, Stroke)

The LIFE-H is able to detect changes (total score effect size = 0.60)

Spinal Cord Disorders (Adult and Pediatrics):

(Fougeyrollas et al. 1998; n = 49, children n = 24, adults n = 25; mean age years = children: 10.9 (4.7), adults: 42.5 (13.1); duration of injury = children: 10.9 (4.7) years, adults: 12.2 (8.2) years; gender = children: 16 female, 8 male; adults: 3 female, 22 male, Spinal Cord Disorders)

• Adequate level of reliability for the children and the adult samples (ICC = 0.73 and 0.74, respectively).
• Taken individually, a majority of life habit categories have shown a adequate to excellent reliability level (ICC >= 0.50) while a few life habit categories such as the interpersonal relationship or nutrition showed a poor reliability level
• Adults with Spinal Cord Injury: ICC = 0.83-0.95

SCI:

(Noonan et al, 2009; Review of SCI instruments, SCI)

• Excellent: Short Form Internal Consistency (alpha > 0.82)
• Adequate: Short Form Internal Consistency (ICC = 0.83)
• Excellent: Long Form Internal Consistency (alpha > 0.90)
• Adequate: Long Form Internal Consistency (ICC = 0.74)

Spinal Cord Injury:

(Dumont et al, 2003; n = 1771; current mean age = 44.5 (15); gender=male 81.4%, SCI)

• Rasch analysis showed satisfactory measurement properties (person reliability = 0.91), and high agreement with expert opinion (items hierarchy r = 0.89)
• Item difficulty hierarchy from spinal cord injury experts differed from hierarchy from traumatic brain injury experts, suggesting that the construct varies across impairment groups

Convergent Validity

(Noreau et al, 1998; n = 482; mean age = 42 (12) years; no other information available; information from abstract, SCI)

• Convergent validity was demonstrated by correlations between grouped LIFE-H items and corresponding CHART dimensions: 0.14 for social integration, through 0.33 and 0.36 for mobility and occupation, to 0.76 for physical independence

SCI:

(Noreau & Fougeyrollas, 2000; n = 482; mean age = 42.4 (12.1); time since injury = 13 (6.8) years; type of injury = Complete Tetraplegia 24.6%, Incomplete Tetraplegia 19.5%, Complete Paraplegia 38.0%, Incomplete Paraplegia 18.3%Chronic SCI)

• The LIFE-H has demonstrated low ceiling effects

Myotonic Dystrophy:

(Gagnon et al, 2006; n = 28; mean age of 52.7 (10.01) years; diagnosed with myotonic dystrophy confirmed by DNA; 2 weeks between assessments, Myotonic Dystrophy)

Myotonic Dystrophy:

(Gagnon et al, 2006; n = 26; mean age of 52.7 (10.01) years; diagnosed with myotonic dystrophy confirmed by DNA; 2 weeks between assessments)

Multiple diagnosis (Neurologic, amputation, coronary, pulmonary, rheumatic disorder , other):

Convergent Validity

(Lemmens, et al, 2007; n = 63, mean age = 69 (7.7), chronic illness n = 66 (7.9); gender = male 56%, Multiple Diagnoses)

The correlations between the LIFE-H categories and total scores and the Impact on Participation and Autonomy Questionnaire (0.80-0.82) and London Handicap Scale (0.89-0.92) were excellent.

IPA=Impact on Participation and Autonomy, LHS= London Handicap Scale

Discriminant Validity

(Lemmens, et al, 2007; n = 120, healthy older adults n = 40, patients with chronic illness n = 80; mean age healthy adults = 69 (7.7), chronic illness n = 66 (8.3); gender = healthy adults male 60%, chronic illness male 55%, Multiple Diagnoses)

Significant differences between the healthy and ill subjects for the 10 separate categories (P < 0.01) and the total score (P < 0.001)