Evaluation of Activities of Daily Living Instruments in Cardiac Patients: Narrative Review

The evaluation of assessment instruments through activity of daily living (ADL) in heart disease is done for early intervention. The aim of this study is to investigate the proper instrument for assessing ADL in a cardiac patient.
Material and This study was a narrative review of instruments of screening and assessing ADL in heart disease. A search was conducted using databases including Iran Medex, SID, Mag Iran, Google Scholar, PubMed, ScienceDirect, and Scopus. The instruments were investigated regarding the date of publishing, each activity of ADL, number of items, method of administration/format, parameters used for establishing target intervention outcomes, scoring, time duration of each instrument, and psychometric properties.
From 22 instruments, eight instruments met the criteria and were included. These instruments were all in the form of self-report questionnaire or observation. Among the available instruments, the oldest instrument was invented in 1957 (PULSES Profile) and the most recent one was developed in 2009 [performance measure for ADL (PMADL)-8]. In terms of item, minimum and maximum items for implementation of instrument were listed 8 and 170 for PMADL-8 and Klein-Bell index, respectively. The minimum and maximum administration time duration was 4-6 min (Kansas City Cardiomyopathy Questionnaire) and 60 min (Klein-Bell index).
This study found that some instruments have been used more because of their proficiency subscales in recent years. Furthermore, a comparison of recent and old instruments revealed their evolutionary path. There is a serious lack of proper instrument for ADL evaluation of occupational therapists.