Rationale:

Activities of daily living (ADL) performance is an important but infrequently evaluated aspect of function in patients recovering from coronary artery bypass (CAB). Self-report assessments of function are often used and are typically based on the amount of assistance required for ADL.

Objectives:

The purpose of this study was to determine if ratings of difficulty or pain were more likely to detect deficits in ADL performance than the level of assistance.

Methodology:

This study included 53 patients who had recently undergone CAB. We evaluated ADL performance using 3 subcategories of the Functional Status Index (FSI), mobility, personal care, and hand activities. Under each subcategory of the FSI, subjects rated their level of assistance, difficulty, and pain with activities on a 5-point scale. Subjects completed the FSI 2 weeks and again 2 months following CAB. We used Wilcoxon Signed Ranks Test to compare differences in scores rating assistance to those of difficulty and pain (P <.05).

Results:

Scores rating difficulty were lower for all FSI subcategories than scores rating assistance except personal care at 2 months and hand activities at 2 weeks. Perceived difficulty with ADL performance was reported 15-55% more often than need for assistance with ADL. Scores rating pain were lower for all FSI subcategories except hand activities at 2 weeks. ADL limitations due to pain were reported 16-51% more often that need for assistance with ADL.

Conclusion:

Subjective ratings of difficulty and pain may be more sensitive than level of assistance when evaluating ADL ability in patients recovering from CAB. In this patient population, assessments of functional ability that rely only on level of assistance may underestimate the presence of functional deficits.