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Rehab Measures: Activity Card Sort

Link to instrument

Information about the ACS is available on the publishers website 

Title of Assessment

Activity Card Sort 

Acronym

ACS

Instrument Reviewer(s)

Summary Date

 

Purpose

Used by occupational therapists to help clients describe their social, instrumental, and leisure activities.

Description

  • Designed to help patients describe their occupational histories
  • Can be used to:
    • Identify lost activities
    • Set goals
    • Monitor rehabilitation
  • Composed of 89 photographs depicting the performance of various activities. 
  • Three versions of the ACS are available, these include:
    • Institutiona
    • Recovering
    • Community Living
  • Information is used by clinicians to design patient-centered interventions. 
  • Items include:
    • 20 instrumental activities
    • 35 low-physical-demand leisure activities
    • 17 high-physical-demand leisure activities
    • 17 social activities

Area of Assessment

Activities of Daily Living; Life Participation; Occupational Performance 

Body Part

Not Applicable 

ICF Domain

Activity; Participation 

Domain

ADL 

Assessment Type

Patient Reported Outcomes 

Length of Test

60 Minutes or More 

Time to Administer

Unknown

Number of Items

89 

Equipment Required

Testing materials include 89 photo's and response forms.  Both items are available from the publisher

Training Required

Read Manual

Type of training required

Reading an Article/Manual 

Cost

Not Free 

Actual Cost

The Activity card Sort, Second Eition is prices at 140.50 (as of May 15th 2011) and can be purcahsed on AOTA's web site

Age Range

Adult: 18-64 years; Elderly adult: 65+ 

Administration Mode

Paper/Pencil 

Diagnosis

Acquired Brain Injury; Cerebral Palsy; Multiple Sclerosis; Parkinson’s Disease; Peripheral Neuropathy; Spinal Cord Injury; Stroke; Traumatic Brain Injury 

Populations Tested

  • Cancer
  • Stroke
  • SCI
  • TBI

Standard Error of Measurement (SEM)

Not Applicable

Minimal Detectable Change (MDC)

Not Applicable

Minimally Clinically Important Difference (MCID)

Not Applicable

Cut-Off Scores

Not Applicable

Normative Data

Not Established

Test-retest Reliability

Community Dwelling Adults: (Everard et al, 2000; n = 20; aged 65 to 87 years; time between assessments = 74 days)
  • Excellent: ExcelentInstrumental (r = 0.95)
  • Excellent: Social (r = 0.83)
  • Excellent: Low-demand leisure (r = 0.91)
  • Excellent: High-demand leisure activity (r = 0.88)

Elderly Adults: (Albert et al, 2009; n = 375; mean age > 70 years; assessed at baseline and 12 months)

  • Adequate test Retest reliabilitiy (r = 0.74)
Cancer Patients: (Lyons et al, 2010; n = 36; age = 54 (12); diagnosis: Multiple myeloma= 45%, Non-Hodgkin’s lymphoma = 28%, Leukemia = 19%, Hodgkin’s lymphoma = 8%)
 
Summary Statistics for the Proportion of Items for Which Participants Were Reliable in Their Designation of an Activity as Previously Done Versus Not Done Previously on the Activity Card Sort (Modified; N = 29)
Domain

Mean (SD)

Median

95% C.I.

Total score (80 activities)
71.9 (14.2)
72.5
66.5–77.3
Instrumental (20 activities)
81.6 (9.7)
85.0
77.9–85.3
Low-Physical-Demand-Leisure (28 activities)
67.4 (19.8)
71.4
59.8–74.9
High-Physical-Demand-Leisure (17 activities)
64.3 (23.8)
70.6
55.2–73.4
Social (15 activities)
76.1 (18.6)
80.0
69.0–83.2

Interrater/Intrarater Reliability

Not Applicable

Internal Consistency

Cancer Patients: (Lyons et al, 2010)
 
ACSm Internal Consistancy (at 1 and 18 Months)
Domain
Alpah at 1 month*
Alpha at 18 months*
Total score (80 activities)
.87 (Excellent)
.88 (Excellent)
Instrumental (20 activities)
.89 (Excellent)
.46 (Poor)
Low-Physical-Demand Leisure (28 activities)
.54 (Poor)
.80 (Excellent)
High-Physical-Demand Leisure (17 activities)
.81 (Excellent)
.74 (Adequate)
Social (15 activities)
.42 (Poor)
.79 (Adequate)
*cronbach's alpha

Criterion Validity (Predictive/Concurrent)

Community Dwelling Adults: (Everard et al, 2000; n = 20; aged 65 to 87 years)
  • Concurrent validity using the Activity Checklist
    • Excellent: Instrumental (r = 0.90)
    • Excellent: Social (r = 0.78)
    • Excellent: Low-demand leisure (r = 0.82)
    • Excellent: High-demand leisure activity (r = 0.72)

Older Adults: (Doney and Packer, 2008; n = 93, Mean age = 74.82 (8.64) years; Australian sample)

  • Adequate: ACS-Aus CAL scores (mean = 0.807, SD = 0.12) and AAP scores (mean = 38.080, SD = 7.49); r = 0.434

Chronic Stroke: (Hartman-Maei et al, 2007; n = 27; firstevent hemispheric stroke; mean age = 61.59 (7.38) years; Israeli sample)

Domain
Before: Mean (SD)

After: Mean (SD)

p
IADL
20.01 (15.60)

25.23 (15.70)

p = 0.000
Leisure social cultural
37.47 (24.41)

46.39 (19.66)

p = 0.000
Leisure Low physical
44.47 (22.72)

58.06 (22.87)

p = 0.000
Leisure High physical
8.26 (11.51)

15.39 (16.33)

p = 0.001
Total activity level
29.72 (14.99)

38.51 (14.91)

p = 0.000

Construct Validity (Convergent/Discriminant)

Cancer Patients: (Lyons et al, 2010)
 
Correlation of ACSm Total Score Pearson Correlation
Domains
r
Karnofsky Performance Scale
.42
Overall well-being (FACT–G)
.51
Functional well-being (subscale of FACT–G)
.59
Perceived cognitive impairment (FACT–Cog)
.22
ACSm = Activity Card Sort (modified)
FACT–Cog = Functional Assessment of Cancer Therapy–General and Cognitive Scales Cognitive Function subscale
FACT–G = Functional Assessment of Cancer Therapy–General Cognitive Scales
 
Older Adults: (Doney and Packer, 2008)
  • Adequate convergent validity: ACS-Aus CAL scores and PWI scores (mean = 64.760, SD = 10.18) r = 0.354
  • Established discriminative validity: ACS-Aus CAL for a younger group (mean = 0.852, SD = 0.100) and an older gourp (mean = 0.760, SD = 0.120) which were found to be signigicantly different (independent t-test; p = 0.000)

Idiopathic Parkinson Disease: (Duncan & Earhart, 2010; n = 62; Hoehn & Yahr Stages 1–4)

Correlations with other measures of mobility:
BBS
FTSTS
6MWT
FOG-Q
DTWV
FWV
BBS
-
70.16
0.79
70.68
0.63

0.76

FTSTS
-
70.30
70.03
70.27
70.30
6MWT
-
70.44
0.80

0.86

FOG-Q
-
70.35

70.38

DTWV
-

0.85

BBS = Berg Balance Scale
FTSTS = The Five Times Sit to Stand test
6MWT = The Six Minute Walk Test
DTWV = Dual task walking velocity
FWV = Forward walking velocity

Content Validity

Not Statistically Assessed

Face Validity

Not Statistically Assessed

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

Considerations

ACS versions currently available:

  • North American (US)
  • Israeli
  • Hong Kong
  • Australian
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Albert, S. M., Bear-Lehman, J., et al. (2009). "Lifestyle-adjusted function: variation beyond BADL and IADL competencies." Gerontologist 49(6): 767-777. Find it on PubMed

Doney, R. M. and Packer, T. L. (2008). "Measuring changes in activity participation of older Australians: validation of the Activity Card Sort-Australia." Australas J Ageing 27(1): 33-37. Find it on PubMed

Duncan, R. P. and Earhart, G. M. (2010). "Measuring participation in individuals with Parkinson disease: relationships with disease severity, quality of life, and mobility." Disabil Rehabil. Find it on PubMed

Everard, K. M., Lach, H. W., et al. (2000). "Relationship of activity and social support to the functional health of older adults." J Gerontol B Psychol Sci Soc Sci 55(4): S208-212. Find it on PubMed

Hartman-Maeir, A., Eliad, Y., et al. (2007). "Evaluation of a long-term community based rehabilitation program for adult stroke survivors." NeuroRehabilitation 22(4): 295-301. Find it on PubMed

Lyons, K. D., Li, Z., et al. (2010). "Consistency and construct validity of the Activity Card Sort (modified) in measuring activity resumption after stem cell transplantation." Am J Occup Ther 64(4): 562-569. Find it on PubMed 

Year published

2nd Edition, 2008 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 5/13/2011 10:37 AM  by Jason Raad 
Last modified at 12/11/2013 12:57 PM  by Jason Raad