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