The FAC assesses functional ambulation in patients undergoing physical therapy.
1
1 minutes
Adult
18 - 64
yearsInitially reviewed by the Rehabilitation Measures Team; Updated with references from the TBI population by Katie Hays, PT, DPT and the TBI EDGE task force of the Neurology Section of the APTA in 2012.
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 (Vestibular EDGE) 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:
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
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StrokEDGE |
R |
UR |
UR |
Recommendations based on level of care in which the assessment is taken:
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Acute Care |
Inpatient Rehabilitation |
Skilled Nursing Facility |
Outpatient Rehabilitation |
Home Health |
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StrokEDGE |
UR |
R |
UR |
UR |
UR |
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TBI EDGE |
LS |
LS |
LS |
LS |
LS |
Recommendations for use based on ambulatory status after brain injury:
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Completely Independent |
Mildly dependant |
Moderately Dependant |
Severely Dependant |
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TBI EDGE |
NR |
LS |
LS |
NR |
Recommendations for entry-level physical therapy education and use in research:
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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) |
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StrokEDGE |
No |
No |
No |
Not reported |
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TBI EDGE |
No |
Yes |
No |
Not reported |
Tested primarily in stroke population:
(Kollen et al, 2006): FAC scores depend on the timing of comfortable walking speed measurements after stroke
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Acute Stroke: (Mehrholz et al, 2007; n = 55; mean age = 62.8 (10.2) years; average time since stroke= 30.6 (15.5) days (assessed 30 to 60 days after stroke); German sample)
A cutoff of > 4 was more sensitive (100%) than specific (78%) in predicting community ambulation at 6 months
Acute Stoke: (Kollen et al, 2006; n = 73; mean age = 64.8 (10.5) years; mean days from CVA to assessment 8.2 (2.8) days; mean Mini-Mental State Examination score = 26.7 (2.3) points; FAC Scores 3-5 used in analysis)
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Functional Ambulation Categories (FAC) Scores |
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Value at the following week after stroke: |
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FAC Score |
Measurement |
4 |
5 |
6 |
7 |
8 |
9 |
10 |
12 |
14 |
16 |
18 |
20 |
26 |
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3 |
Walking speed (m/s) |
0.45 |
0.43 |
0.37 |
0.45 |
0.33 |
0.39 |
0.38 |
0.35 |
0.33 |
0.29 |
0.30 |
0.30 |
0.19 |
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4 |
Walking speed (m/s) |
0.73 |
0.90 |
0.80 |
0.63 |
0.65 |
0.64 |
0.58 |
0.57 |
0.50 |
0.50 |
0.49 |
0.48 |
0.48 |
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5 |
Walking speed (m/s) |
1.08 |
0.92 |
1.04 |
1.04 |
1.06 |
1.02 |
1.11 |
1.07 |
1.06 |
1.04 |
1.00 |
1.02 |
0.92
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Acute Stroke: (Mehrholz et al, 2007)
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FAC Normative Data: |
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Measure |
Scale |
basline |
2-weeks |
4-weeks |
6-months |
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FAC |
0 - 5 |
0.44 (0.69) |
1.22 (1.32) |
1.98 (1.50) |
2.79 (2.12) |
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RMI |
0 - 14 |
2.51 (1.62) |
4.04 (2.88) |
5.76 (3.93) |
7.38 (5.01) |
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6MWT |
meters |
15.9 (34.3) |
50.9 (81.1) |
83.9 (107.8) |
112.3 (143.9) |
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Walking velocity |
(m/s) |
0.07 (0.14) |
0.19 (0.28 |
0.33 (0.46) |
0.38 (0.51) |
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Step length |
meters |
0.09 (0.13) |
0.18 (0.19) |
0.27 (0.20) |
0.28 (0.26) |
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mean (SD) |
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Acute Stroke: (Mehrholz et al, 2007)
Acute Stroke: (Mehrholz et al, 2007)
Acute Stroke: (Mehrholz et al, 2007):
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Values are Spearman p all with (p< .001) |
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Parameter |
FAC Scores at Baseline |
FAC Scores After 2 Weeks |
FAC Scores After 4 Weeks |
FAC Scores at 6-Month Follow-Up |
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RMI |
0.686 |
0.787 |
0.825 |
0.893 |
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6MWT |
0.949 |
0.937 |
0.931 |
0.906 |
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Walking velocity |
0.952 |
0.939 |
0.902 |
0.901 |
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Step length |
0.952 |
0.932 |
0.896 |
0.877 |
Acute stroke: (Kollen et al, 2006):
Stroke: (Salter et al, 2008, overall review of measure)
Acute Stroke: (Mehrholz et al, 2007)
FAC scores changed significantly between:
Stroke: (Salter et al, 2008)
(Kollen et al, 2006)
Stroke and Multiple Sclerosis: (Holden et al, 1984; n=61(n=24 with MS, mean age= 39(9.8) years, n=37 with hemiparesis, mean age=51(17) years):
Collen, F. M., Wade, D. T., et al. (1990). "Mobility after stroke: reliability of measures of impairment and disability." Int Disabil Stud 12(1): 6-9.
Holden, M. K., Gill, K. M., et al. (1986). "Gait assessment for neurologically impaired patients. Standards for outcome assessment." Phys Ther 66(10): 1530-1539.
Kollen, B., Kwakkel, G., et al. (2006). "Time dependency of walking classification in stroke." Phys Ther 86(5): 618-625.
Martin, B. and Cameron, M. (1996). "Evaluation of walking speed and functional ambulation categories in geriatric day hospital patients." Clinical rehabilitation 10(1): 44.
Mehrholz, J., Wagner, K., et al. (2007). "Predictive validity and responsiveness of the functional ambulation category in hemiparetic patients after stroke." Arch Phys Med Rehabil 88(17908575): 1314-1319.
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.