Skip to main content

Table 1 Categories and items of the Early Functional Abilities (EFA) scale

From: The Early Functional Abilities (EFA) scale to assess neurological and neurosurgical early rehabilitation patients

Categories

Items

Rating [1–5]

A) Vegetative functions

1) Autonomic stability

1- Instable even at rest, monitoring required

2 - Stable at rest but requires monitoring at least temporarily

3 - Stable at rest and during nursing, no monitoring required

4 - Slightly instable only during rehabilitation therapy

5 - No marked changes in blood pressure, heart rate or perspiration during nursing or rehabilitation therapy

 

2) Wakefulness

1 - Lack of regular sleep-wake cycle, nocturnal agitation, sleepy during the day

2 - Infrequent nocturnal agitation and sleepy during the day

3 - Regular sleep-wake-cycle established

4 - Fatigued after rehabilitation therapy of 10-60 min duration

5 - No fatigue, even after rehabilitation therapy of more than 60 min

 

3) Tolerance to postural changes

1 - Only supine position is tolerated well, lying on one side less than 20 min

2 - Lying on one side tolerated 20-60 min

3 - Lying on one side tolerated 60-120 min

4 - Lying on one side tolerated more than 120 min

5 - Complete tolerance to postural changes

 

4) Excretion functions (continence)

1 - No faecal and urinary continence at all, urinary catheter

2 - Use of diaper or urine bottle where possible

3 - Use of toilet-chair where possible, no urinary catheter

4 - Continence during the day, nocturnal incontinence

5 - Faecal and urinary continence

 

Category score

4 to 20 points

B) Oro-facial-functions

5) Oro-facial stimulation/oral hygiene

1- No cooperation, no reaction to oro-facial stimulation

2 - No cooperation, minor reactions upon stimulation

3 - Partial cooperation (e.g. opening mouth)

4 - Good cooperation during oral hygiene

5 - Oral hygiene carried out independently (e.g. toothbrushing)

 

6) Swallowing

1 - No/infrequent swallowing of saliva, high danger of aspiration

2 - Swallowing of saliva improved, still danger of aspiration

3 - Swallowing of mush possible, drinking still dangerous (aspiration)

4 - No disturbance of swallowing of food, drinking infrequently disturbed

5 - No disturbance of eating and drinking

 

7) Tongue movements/chewing

1 - No tongue movements, no chewing

2 - Severely disturbed chewing

3 - Chewing improved, tongue movements severely disturbed

4 - Tongue movements improved

5 - No disturbance of tongue movements or chewing.

 

8) Facial expression

1 - No facial expression/reaction

2 - Some spontaneous facial expression/reaction

3 - Infrequent spontaneous and voluntary facial expression

4- Slightly disturbed voluntary facial expression

5 - Regular facial expression.

 

Category score:

4 to 20 points

C) Sensorimotor abilities

9) Muscle tone

1 - No modulation of muscle tone (spastic or floppy)

2 - Some modulation of muscle tone may be observed in unaffected limbs

3 - Improved modulation and holding of muscle tone

4 - Good modulation and holding of muscle tone in unaffected limbs

5 - Normal modulation and holding of muscle tone in supine position

 

10) Head postural control

1 - No head postural control at all

2 - Severely disturbed head postural control during rehabilitation therapy

3 - Infrequently raising the head

4 - Holding up the head for up to 10 min

5 - Normal head posture, longer thann 10 min

 

11) Trunk postural control/sitting

1 - No sitting at all

2 - Passive sitting

3 - Active sitting, infrequentl correction of trunk position

4 - Active sitting without any help, less than 10 min, still some problems in keeping balance

5 - Physiological trunk posture; sits without help more than 10 min

 

12) Changing position

1 - No voluntary changes of position

2 - Changes position with help from 1-2 nurses

3 - Changes position with little help from 1 nurse

4 - Changes position almost without any help

5 - Can stand up from a lying position without any help.

 

13) Standing

1 - No standing at all.

2 - Stands (passively) only 5-10 min with help from 2 nurses

3 - Stands (passively) more than 10 min with help from 2 nurses

4 - Stands (actively) with help from only 1 nurse

5 - Stands without help

 

14) Voluntary movements

1 - No voluntary movements

2 - Infrequent voluntary movements (e.g. aversion motions)

3 - Grasps, but does not let go

4 - Slight disturbance of grasping and letting

5 - No disturbance of voluntary movements

 

15) Locomotion/mobility in wheelchair

1 - No use of a wheelchair at all

2 - Passive transport in wheelchair

3 - Patient has trunk and head postural control in wheelchair

4 - Active use of wheelchair by the patient or walking some steps

5 - Independent mobility in wheelchair or ambulation without help

 

Category score:

7 to 35 points

D) Cognitive abilities

16) Tactile stimulation

1 - No response to tactile stimulation

2 - Nonspecific response to stimulation (e.g. agitation, heart rate or muscle tone changes)

3 -Voluntary response to stimulation, in particular aversion

4 - Grasping or other targeted actions

5 - Adequate reactions to tactile stimulation

 

17) Visual stimulation

1 - No response to visual stimulation

2- Nonspecific response or short eye contact

3 -Voluntary response to stimulation, eye contact

4 - Targeted actions, eyes search the environment

5 - Adequate reactions to visual stimulation

 

18) Auditory stimulation

1 - No response to auditory stimulation

2 - Nonspecific response to stimulation (e.g. agitation, heart rate or muscle tone changes)

3 - Voluntary response to stimulation, orientation of eye or head movement to the stimulus

4 - Different reactions to familiar /unfamiliar voices

5 - Assimilation of acoustic information over longer periods of time.

 

19) Communication

1 - None.

2 - Low-level communication (e.g. expression of discomfort)

3 - Infrequent adequate responses

4 - Patient is able to answer with yes/no

5 - Talking or communicating without problems

 

20) Comprehension

1 - None

2 - Nonspecific reactions (e.g. muscle tone changes)

3 - Patient is more cooperative, partial comprehension of the situation, apractic/agnostic

4 - Comprehension improved, no apraxia/agnosia

5 - No disturbance of activities of daily living.

 

Category score:

5 to 25

 

EFA total score:

20 to 100 points