Quality of Life Concepts

Secondary Health Conditions

Klein & Bell Activities of Daily Living (ADL) Index

Description: A measure of ADL independence for both children and adults [1].

Format:  170 items covering 6 domains: dressing, mobility, elimination, bathing and hygiene, eating, and emergency communication.

Scoring: Each subtask is weighted on a scale from 1 to 3 while considering four factors: importance to health, difficulty for non-disabled persons, time required to perform it, and associated burden of care giving. The total score can range from 0 to 313, with higher scores reflecting greater independence.

Administration and Burden: Interviewer-administered; 1-3 hours to administer.

Psychometrics for SCI: The Klein & Bell has been shown to be a valid and reliable measure for SCI [2].

Languages: English, Spanish.

QoL Concept: The Klein & Bell ADL Index measures independence in performing Activities of Daily Living, which corresponds to Box C (achievements; activities of daily living) of Dijker’s Model.

Permissions/Where to Obtain: Copyrighted; The Klein & Bell ADL Index can be obtained from:

References:

  1. Klein RM, Bell B. The Klein and Bell ADL Scale Manual. In: Washington Uo, editor. Seattle, WA: Educational Resources; 1979.

  2. Dahlgren A, Karlsson A-K, Lundgren Nilsson Å, Fridén J, Claesson L. Activity performance and upper extremity function in cervical spinal cord injury patients according to the Klein-Bell ADL Scale. Spinal Cord 2007;45:475-84.

CLICK ON THE LISTED SECONDARY HEALTH CONDITIONS ON THE LEFT TO READ HOW THE ADL INDEX HAS BEEN USED WITH A PARTICULAR CONDITION


Pain SCI Studies: One cross-sectional survey.

  1. Samuelsson KAM, Tropp H, Gerdle B. Shoulder pain and its consequences in paraplegic spinal cord-injured wheelchair users. Spinal Cord 2004;42:41-6.

Sensitivity to Impact: Samuelsson and colleagues (2004) used the Wheelchair User's Shoulder Pain Index (WUSPI), the Constant Murley Scale (CMS), the Klein & Bell ADL Index, and the Canadian Occupational Performance Measure (COPM) to describe the consequences of shoulder pain on activity and participation in persons with paraplegia (N = 56). The highest pain intensities, as assessed by the WUSPI, were found for the activities: ‘load wheelchair into a car’, followed by ‘pushing up ramps or inclines outdoor’ and ‘usual daily activities at work or school’. No significant differences were found in activities of daily living performance between persons with pain and those without.

Suggestions for Use: Samuelsson and colleagues (2004) stated that the Klein & Bell ADL Index may be insensitive to the impact of shoulder pain since the scale consists of items that persons can perform regardless of pain.

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