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V. L. Gills, M. MacKeben, D. C. Fletcher; A New Timed Instrumental Activities of Daily Living (TIADL) Measure for Evaluation of Rehabilitation Outcomes. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3558.
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To evaluate a new timed instrumental activities of daily living (TIADL) measure in AMD patients after low vision rehabilitation as an assessment of real world function.
The new TIADL measure was performed on 8 AMD patients after their having completed a low vision rehabilitation program which included physician evaluation and several sessions of OT training. Necessary vision enhancement equipment was provided for the patients and they were given several months to implement them into daily routines. Patients were visited in their home and asked to complete 6 tasks which were timed. TIADL tasks included: (1) Reading a mock phone bill to identify the amount due ($11.00). (2) Writing a check for this amount. (3) Identifying the $11 cash amount from a $20, $10, $5, and $1 bill. (4) Finding a number in a phone book. (5) Dialing the number on a standardized phone. (6) Identifying all the queens in a playing card display of face cards. Task timing was cut off at 1000 seconds.
Patient’s age median/range was 85/79-91. They covered a wide range of impairment levels with best corrected visual acuity median (range), 20/142 (20/76 to 20/553). TIADL task completion time median/range was (1) 31.1/8.0-141.0 (2) 34.0/2.9-1000.0 (3) 15.0/7.7-45.0 (4) 103.5/8.0-1000.0 (5) 20.5/8.1-1000.0 (6) 27.5/5.0-114.0 seconds. Total time to complete all tasks median/range was 231.6/48.0-3217.0 seconds. As visual acuity decreased the task completion times increased but not all of the variance was accounted for by acuity alone (rsq=0.3).
These six TIADL tasks show a good spread in time to complete with some easy tasks completed quickly by all subjects and some more complex tasks requiring considerable time. They appear to separate out various performance levels. The wide range of time to complete these simple daily activities shows wide variation in response to rehabilitation. While it is clear that decreasing acuity generally increases time to perform these tasks, there are likely many other factors involved. This may represent a useful real world performance measure for assessing response to rehabilitation.
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