Skip to main content
  

Rehab Measures: Assessment of Life Habits

Link to instrument

Find Information for the LIFE-H at iNDCP 

Title of Assessment

Assessment of Life Habits 

Acronym

Life-H

Instrument Reviewer(s)

Initially reviewed by the Rehabilitation Measures Team; Updated by Sue Saliga, PT, MS, DHSc, Anna de Joya, PT, MS, NCS, and the TBI EDGE task force of the Neurology Section of the APTA in 2012; Updated by Ashley Marrapode, SPT, Taylor McCulloch. SPT, Kristy Samra, SPT in 11/2012. 

Summary Date

4/25/2013 

Purpose

Assesses participants on 77 life habits from daily activities to social participation across 12 domains. It is a self-report based on one’s perception of difficulty and assistance required.

Description

The LIFE-H is composed if two scales.
The first assesses accomplishments rated across two dimensions:
  1. The degree of difficulty experienced
  2. The kind of assistance required (help, technical assistance, physical arrangements)

Life-H Accomplishments Scale:
Score
Level of Difficulty
Type of Assistance
9
Accomplished with no difficulty
No assistance
8
Accomplished with no difficulty
Assistive device or adaptation
7
Accomplished with difficulty
No assistance
6
Accomplished with difficulty
Assistive device or adaptation
5
Accomplished with no difficulty
Human assistance
4
Accomplished with no difficulty
Assistive device or adaptation and human assistance
3
Accomplished with difficulty
Human assistance
2
Accomplished with difficulty
Assistive device or adaptation and human assistance
1
Accomplished by a proxy
0
Not accomplished
N/A Not applicable

The second scale assesses the patient's satisfaction with daily activities or social roles. The satisfaction can range from 1 to 5 (with 5 indicating a high level of satisfaction)

Life-H Daily Activities Domain:
Category
Items example
Nutrition
Preparing your meal
Eating in restaurants
Fitness
Sleep
Participating in physical activities to maintain or improve your health
Personal care
Attending to your personal hygiene
Using a bathroom or toilet other than those in your home
Communication
Communicating with another person at home or in the community
Written communication
Housing
Maintaining your home
Doing major household tasks
Mobility
Getting around on slippery or uneven surfaces
Driving a vehicle
Social Roles Domain:
Category
Items example
Responsibility
Making purchases
Taking care of your children
Interpersonal relationships Maintaining friendships
Having a sexual relationship
Community life Getting to public buildings in your community
Participating in spiritual or religious practices
Education Participating in educational activities or vocational training
Undertaking vocational training
Work Holding a paid job
Carrying out familial or home-making tasks as your main occupation
Recreation Participating in sporting or recreational activities
Taking part in outdoor activities

Area of Assessment

Activities of Daily Living; Communication; Eating; Executive Function; Life Participation; Quality of Life 

Body Part

Not Applicable 

ICF Domain

Activity; Participation 

Domain

ADL 

Assessment Type

Performance Measure 

Length of Test

06 to 30 Minutes 

Time to Administer

LIFE-H 3.1 short form: 20-40 minutes; LIFE H 3.0 long form: 20-120 minutes

Number of Items

General long form 242 items over 12 domains; General short form 77 items over 12 domains; Children long form 240 items; Children short form 62 items 

Equipment Required

Find a sample of the manual here

Training Required

None. Test manuals are available from iNDCP.

Type of training required

No Training; Reading an Article/Manual 

Cost

Not Free 

Actual Cost

Information about purchasing the LIFE-H can be found at the iNDCP

Age Range

Infant: birth-23 months; Preschool Child: 2-5 years; Child: 6-12 years; Adolescent: 13-17 years; Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Cerebral Palsy; Multiple Sclerosis; Spinal Cord Injury; Stroke 

Populations Tested

  • Cerebral Palsy
  • Geriatrics
  • Multiple Sclerosis
  • Older adults with disabilities
  • Pediatrics
  • SCI
  • Stroke
  • Traumatic Brain Injury

Standard Error of Measurement (SEM)

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
LIFE-H categories
SEM
Nutrition
1.25
Fitness
1.51
Personal care
0.89
Communication
0.89
Residence
1.25
Mobility
1.60
Responsibility
1.38
Social relations
1.60
Community
0.99
Education

N/A

Employment

N/A

Recreation

1.56

Daily activities

0.78

Social roles

0.92

Total score

0.76

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)

LIFE-H

SEM

Personal care

0.47

Nutrition

0.70

Housing

0.56

Mobility

1.03

Communication

0.55

Fitness

1.34

Daily Activities Sub-score

0.24

Responsibility

0.40

Community life

0.78

Recreation

2.15

Interpersonal relationships

--

Education/Employment

N/A

Social Roles Sub-score

0.49

Total Score

0.25

Minimal Detectable Change (MDC)

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)

LIFE-H

MDC

Personal care

1.30

Nutrition

1.93

Housing

1.56

Mobility

2.85

Communication

1.52

Fitness

3.71

Daily Activities Sub-score

0.67

Responsibility

1.10

Community life

2.17

Recreation

5.95

Interpersonal relationships

--

Education/Employment

N/A

Social Roles Sub-score

1.36

Total Score

0.68

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Older Adults:
(Desrosiers et al, 2009; n = 350 randomly recruited community-dwelling elderly adults, Older Adults)
 
Life-H Norms by Age Group:

Age Range

Daily activities
p
65–69
70–74
75–79
80–84
85+
Nutrition
0.97
8.1 (1.3)
7.9 (1.2)
8.0 (1.4)
8.0 (1.4)
7.9 (1.1)
Fitness
0.06
8.6 (0.9)
8.6 (0.5)
8.7 (0.5)
8.4 (0.8)
8.4 (0.8)
Personal care
< 0.001
8.9 (0.2)
8.8 (0.3)
8.8 (0.3)
8.7 (0.3)
8.6 (0.4)
Communication
< 0.001
8.8 (0.3)
8.6 (0.6)
8.7 (0.4)
8.5 (0.7)
8.3 (0.9)
Housing
0.003
7.6 (0.9)
7.3 (0.9)
7.2 (0.8)
7.5 (0.9)
7.1 (0.9)
Mobility
< 0.001
8.6 (0.7)
8.6 (0.6)
8.2 (1.1)
7.9 (1.2)
7.5 (1.7)
Daily activities subscore
< 0.001
8.4 (0.3)
8.3 (0.3)
8.3 (0.4)
8.2 (0.4)
8.0 (0.5)
Social roles
p
65–69
70–74
75–79
80–84
85+
Responsibilities
0.09
8.3 (0.8)
8.3 (0.8)
8.5 (0.7)
8.5 (0.9)
8.2 (1.0)
Interpersonal relationships
0.46
8.5 (0.8)
8.6 (0.8)
8.5 (1.0)
8.7 (0.7)

8.4 (1.0)

Community life < 0.001

8.8 (0.7)

8.7 (0.6)

8.6 (0.8)

8.5 (1.0)

8.1 (1.6)

Leisure < 0.001

7.5 (1.5)

7.9 (1.3)

7.0 (2.2)

7.4 (2.0)

6.4 (2.5)

Social roles subscore < 0.001

8.4 (0.5)

8.5 (0.5)

8.3 (0.6)

8.4 (0.7)

7.9 (1.0)

Total score < 0.001

8.4 (0.3)

8.4 (0.3)

8.3 (0.4)

8.3 (0.5)

8.0 (0.6)

Test-retest Reliability

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

 

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)

LIFE-H Categories
ICC
Daily Activities
Personal Care
Excellent
0.97
Nutrition
Excellent
0.90
Housing
Excellent
0.78
Mobility
Excellent
0.76
Communication
Excellent
0.75
Fitness
Poor
0.30
Subscore
Excellent
0.96
Social Roles
Responsibility
Excellent
0.89
Community Life
Excellent
0.83
Recreation
0.55
Interpersonal Relationships
Limited info
--
Subscore
Excellent
0.76
Total Score
Excellent
0.95

 

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)

LIFE-H Test re-test Reliability
Category
T1 Mean (SD)
T2 Mean (SD)
Strength
ICC
Nutrition
8.1 (2.1)
8.4 (1.9)
Excellent
0.92
Personal Care
8.8 (1.4)
9.0 (1.1)
Adequate
0.86
Mobility
6.2 (3.4)
6.5 (2.8)
Adequate
0.79
Housing
6.1 (1.9)
6.7* (1.4)
Poor
0.73
Fitness
8.5 (1.5)
9.1* (1.2)
Poor
0.20
Communication
9.5 (0.6)
9.6 (0.4)
Poor
0.12
Daily Activities Subscore
8.0 (1.3)
8.3* (1.0)
Adequate
0.80
Interpersonal Relationships
8.6 (1.6)
8.6 (1.7)
Adequate
0.87
Community Life
6.6 (3.6)
6.6 (3.5)
Adequate
0.83
Recreation
6.3 (3.0)
7.4* (3.5)
Adequate
0.79
Responsibility
8.1 (2.2)
8.5 (1.7)
Adequate
0.76
Social Roles Subscore
7.2 (2.2)
7.4 (1.9)
Excellent
0.91
LIFE_ (total score)
7.7 (1.6)
7.9* (1.3)
Adequate
0.86
*p < 0.05

 

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

LIFE-H Categories
ICC
Nutrition
Adequate
0.72
Fitness
Adequate
0.47
Personal Care
Excellent
0.88
Communication
Excellent
0.81
Residence
Adequate
0.57
Mobility
Adequate
0.55
Responsibility
Adequate
0.68
Social Relations
Poor
0.21
Community
Excellent
0.87
Education
NA
Employment
NA
Recreation
Adequate
0.66
Daily Activities
Excellent
0.78
Social Roles
Excellent
0.78
Total Score
Excellent
0.80

 

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

Interrater/Intrarater Reliability

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

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

 

Dimensions

ICC

ICC

Daily Activities

Communication

Excellent

0.95

Excellent

0.91

Personal Care

Excellent

0.94

Excellent

0.92

Housing

Excellent

0.93

Excellent

0.93

Mobility

Excellent

0.91

Excellent

0.88

Nutrition

Excellent

0.86

Excellent

0.82

Fitness

Excellent

0.83

Excellent

0.80

Social Roles

Recreation

Excellent

0.92

Excellent

0.87

Responsibility

Excellent

0.90

Excellent

0.91

Education

Excellent

0.90

Excellent

0.82

Community Life

Excellent

0.78

Excellent

0.78

Interpersonal Relationships

Adequate

0.58

Adequate

0.63

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)

  • 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

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)

LIFE-H

ICC

Level of Reliability

Nutrition

0.72

Adequate

Fitness

0.33

Poor

Personal Care

0.95

Excellent

Communication

--

---

Housing

0.49

Adequate

Mobility

0.61

Adequate

Daily activities sub-score

0.91

Excellent

Responsibilities

0.72

Adequate

Interpersonal relationships

--

---

Community life

0.70

Adequate

Leisure/Recreation

0.55

Adequate

Education/Employment

N/A

N/A

Social roles sub-score

0.64

Adequate

Total Score

0.89

Excellent

 
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)
 
LIFE-H Inter-rater reliability
Category
T2 Mean (SD)
T3 Mean (SD)

Strength

ICC
Personal care
9.0 (1.1)
8.7 (1.4)

Adequate

0.87

Mobility
6.2 (2.8)
6.3 (2.7)

Adequate

0.84

Housing
6.6 (1.4)
6.7 (1.8)

Adequate

0.76

Nutrition
8.3 (1.9)
8.5 (1.6)
Poor

0.68

Communication
9.6 (0.4)
9.5 (0.6)
Poor

0.47

Fitness
9.1 (1.2)
8.4* (1.3)
Poor

0.21

Daily activities subscore
8.3 (1.0)
8.0 (1.3)

Adequate

0.86

Responsibility
8.5 (1.7)
9.2* (1.0)
Poor

0.56

Interpersonal relationships
8.6 (1.7)
8.7 (1.7)

Adequate

0.84

Community life
6.5 (3.5)
6.5 (3.7)

Excellent

0.93

Recreation
7.0 (3.7)
6.8 (3.4)

Adequate

0.75

Social roles subscore

7.4 (1.9)

7.6 (1.9)

Excellent

0.92

LIFE-H (total score)

7.9 (1.3)

7.8 (1.5)

Excellent

0.90

*p < 0.05

 

Internal Consistency

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

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)

Criterion Validity (Predictive/Concurrent)

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

Construct Validity (Convergent/Discriminant)

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

LIFE-H for Children

PEDI Functional Skills

PEDI Caregiver Assistance

Self-Care

Mobility

Social Function

Self-care

Mobility

Social Function

Nutrition

0.71

0.67

0.70

0.71

0.64

0.69

Fitness

0.68

0.69

0.63

0.70

0.73

0.56

Personal care

0.79

0.82

0.61

0.88

0.80

0.57

Communication

0.76

0.61

0.81

0.75

0.62

0.79

Housing

0.79

0.88

0.61

0.81

0.84

0.55

mobility

0.56

0.68

0.40

0.63

0.65

0.32

Responsibility

0.70

0.67

0.80

0.71

0.66

0.76

Interpersonal Relationships

0.51

0.50

0.66

0.50

0.48

0.63

Community Life

0.54

0.53

0.47

0.58

0.52

0.44

Education

0.69

0.69

0.60

0.74

0.65

0.56

Recreation

0.68

0.71

0.60

0.74

0.68

0.53

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

 

Multiple diagnosis (Neurologic, amputation, coronary, pulmonary, rhematic 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.

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)

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.

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

 

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)

 
LIFE-H, SMAF & FIM Correlations: 
 
Time 3 (n = 118)
Time 4 (n = 102)
LIFE-H Domain
SMAF (total score)
FIM (total score)
p value
SMAF (total score)
FIM (total score)
p value
LIFE-H (total score)
0.85*
0.79
0.001
0.89
0.85

0.006

Personal care
0.87
0.85
0.13
0.92
0.90
0.08
Housing
0.70
0.65
0.02
0.77
0.74
0.11
Nutrition
0.69
0.63
0.009
0.63
0.61
0.17
Mobility
0.59
0.52
0.005
0.62
0.58
0.08
Communication
0.52
0.52
1.00
0.56
0.56
1.00
Fitness
0.38
0.38
1.00
0.58
0.58
1.00
Daily activities subscore
0.89
0.85
0.007
0.91
0.88
0.03
Responsibility
0.68
0.63
0.03
0.72
0.64
0.001
Community
0.66
0.57
0.001
0.74
0.67
0.001
Education/ employment
0.45
0.35
0.001
0.49
0.43
0.02
Leisure

0.22

0.21

0.73

0.32

0.31

0.71

Interpersonal relationships

0.06

0.05

1.00

0.30

0.33

0.26

Social roles subscore

0.66

0.57

0.001

0.77

0.71

0.006

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

Stroke :

(Desrosiers et al, 2005; nstroke= 46, nhealthy= 46; mean agestroke= 72.5 (11.5) years, mean age healthy= 73.0 (11.4)years; time post stroke = 4-6 years; French and English sample, Stroke)

LIFE-H- Comparison between stroke patients and healthy elderly

Difference (1-ratio) and (95% CI)

Nutrition

0.45 (0.35-0.55)

Fitness

0.25 (0.18-0.31)

Personal Care

0.39 (0.30-0.47)

Communication

0.21 (0.09-0.32)

Housing

0.31 (0.22-0.39)

Mobility

0.33 (0.21-0.44)

Daily activities sub-score

0.33 (0.26-0.39)

Responsibilities

0.19 (0.09-0.28)

Interpersonal relationships

0.01 (-0.08-0.06)

Community life

0.47 (0.35-0.48)

Leisure/Recreation

0.38 (0.12-0.63)

Education/Employment

0.69 (0.44-0.95)

Social roles sub-score

0.24 (0.16-0.31)

Total Score

0.29 (0.22-0.36)

Content Validity

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

Face Validity

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

Floor/Ceiling Effects

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
 
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

Responsiveness

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)

LIFE-H

Effect Size T3-T1

Nutrition

0.35

Fitness

0.54

Personal Care

0.67

Communication

0.35

Housing

0.67

Mobility

0.44

Daily activities sub-score

0.64

Responsibilities

0.29

Interpersonal relationships

0.33

Community life

0.60

Leisure/Recreation

1.41

Education/Employment

0.14

Social roles sub-score

0.56

Total Score

0.60

Professional Association Recommendations

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 (VEDGE) 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:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

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 months post)

Subacute

(CVA 2 to 6 months)

(SCI 3 to 6 months)

Chronic

(> 6 months)

StrokEDGE

NR

R

R

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

StrokEDGE

NR

R

R

R

R

TBI EDGE

NR

NR

NR

LS

LS

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

N/A

N/A

N/A

N/A

 

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

Yes

Yes

Not reported

TBI EDGE

No

Yes

Yes

Not reported

Considerations

Evidence Based Review for Research (Magasi et al, 2007). The group identified the following considerations:

  • Low ceiling effects
  • The satisfaction scale appears to have little empirical support
  • Limited use in clinical practice and research
  • Conceptual foundation not widely known

Translations Available:

  • Danish
  • French
  • German
  • Italian
  • Swedish

Stroke:

(Poulin and Desrosiers, 2008; nstroke = 40, nproxy = 40; mean age of stroke patients = 73.6 (8.4) years; mean time post stroke = 43.5 (32.0) months; French sample, Stroke)

  • Excellent level of agreement between stroke patients and their proxies (ICC = 0.82) suggests that proxies are able to complete LIFE-H when stroke patients are unable to respond

LIFE-H

ICC

Level of Reliability

Nutrition

0.76

Excellent

Fitness

0.61

Adequate

Personal Care

0.93

Excellent

Communication

0.59

Adequate

Housing

0.83

Excellent

Mobility

0.86

Excellent

Daily activities sub-score

0.87

Excellent

Responsibilities

0.63

Adequate

Interpersonal relationships

0.41

Adequate

Community life

0.92

Excellent

Leisure

0.82

Excellent

Education/Employment

N/A

N/A

Social roles sub-score

0.73

Adequate

Total Score

0.82

Excellent

Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Desrosiers, J., Bourbonnais, D., et al. (2005). "Participation after stroke compared to normal aging." J Rehabil Med 37(6): 353-357. Find it on PubMed

Desrosiers, J., Robichaud, L., et al. (2009). "Comparison and correlates of participation in older adults without disabilities." Arch Gerontol Geriatr 49(3): 397-403. Find it on PubMed

Desrosiers, J., Rochette, A., et al. (2003). "Comparison of two functional independence scales with a participation measure in post-stroke rehabilitation." Arch Gerontol Geriatr 37(2): 157-172. Find it on PubMed

Dumont, C., Bertrand, R., et al. (2003). "Rasch modeling and the measurement of social participation." J Appl Meas 4(4): 309-325. Find it on PubMed

Fougeyrollas, P., Noreau, L., et al. (1998). "Social consequences of long term impairments and disabilities: conceptual approach and assessment of handicap." Int J Rehabil Res 21(2): 127-141. Find it on PubMed

Gagnon, C., Mathieu, J., et al. (2006). "Measurement of participation in myotonic dystrophy: reliability of the LIFE-H." Neuromuscul Disord 16(4): 262-268. Find it on PubMed

Lemmens, J., E, I. S. M. v. E., et al. (2007). "Reproducibility and validity of the Dutch Life Habits Questionnaire (LIFE-H 3.0) in older adults." Clin Rehabil 21(9): 853-862. Find it on PubMed

Magasi, S. R., Heinemann, A. W., et al. (2008). "Participation following traumatic spinal cord injury: an evidence-based review for research." J Spinal Cord Med 31(2): 145-156. Find it on PubMed

Morris, C., Kurinczuk, J. J., et al. (2005). "Child or family assessed measures of activity performance and participation for children with cerebral palsy: a structured review." Child Care Health Dev 31(4): 397-407. Find it on PubMed 

Noonan, V. K., Miller, W. C., et al. (2009). "A review of instruments assessing participation in persons with spinal cord injury." Spinal Cord 47(6): 435-446. Find it on PubMed

Noreau, L., Desrosiers, J., et al. (2004). "Measuring social participation: reliability of the LIFE-H in older adults with disabilities." Disabil Rehabil 26(6): 346-352. Find it on PubMed

Noreau, L. and Fougeyrollas, P. (2000). "Long-term consequences of spinal cord injury on social participation: the occurrence of handicap situations." Disabil Rehabil 22(4): 170-180. Find it on PubMed

Noreau, L., Fougeyrollas, P., et al. (2002). "The LIFE-H: Assessment of the quality of social participation." Technology and Disability 14(3): 113-118.

Noreau, L., Lepage, C., et al. (2007). "Measuring participation in children with disabilities using the Assessment of Life Habits." Developmental Medicine & Child Neurology 49(9): 666-671.

Poulin, V. and Desrosiers, J. (2008). "Participation after stroke: comparing proxies' and patients' perceptions." J Rehabil Med 40(1): 28-35. Find it on PubMed 

Poulin, V. and Desrosiers, J. (2009). "Reliability of the LIFE-H satisfaction scale and relationship between participation and satisfaction of older adults with disabilities." Disability & Rehabilitation 31(16): 1311-1317.

Rochette, A., Desrosiers, J., et al. (2007). "Changes in participation after a mild stroke: quantitative and qualitative perspectives." Top Stroke Rehabil 14(3): 59-68. Find it on PubMed

Sakzewski, L., Boyd, R., et al. (2007). "Clinimetric properties of participation measures for 5- to 13-year-old children with cerebral palsy: a systematic review." Dev Med Child Neurol 49(3): 232-240. Find it on PubMed

Sakzewski, L., Ziviani, J., et al. (2011). "Participation outcomes in a randomized trial of 2 models of upper-limb rehabilitation for children with congenital hemiplegia." Arch Phys Med Rehabil 92(4): 531-539. Find it on PubMed

Tse, T., Douglas, J., et al. (2013). "Measuring participation after stroke: a review of frequently used tools." Arch Phys Med Rehabil 94(1): 177-192. Find it on PubMed

Year published

1997 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 4/12/2011 1:53 PM  by Jason Raad 
Last modified at 8/28/2014 3:20 PM  by Jason Raad