Assessment tools for evaluating Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) are very important. These instruments are developed in especial context and especial community. Given the increase in the number of the ageing population, it is important to identify the barriers and performance problems of this community by these tools.

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Background: Katz Index is a well-known index for assessing basic activities of daily living. The aim was to determine validity and reliability of the Katz Index in Iranian patients with acute stroke. Methods: Eighty-seven patients (56 male, 31 female) with acute stroke (1-30 days post-stroke) participated in this psychometric properties study. Interval time for retest was 14 days. All participants were Iranian with Persian as native language, had no other major diseases (e.g. cancer, Alzheimer) and no psychiatric disorder. Cognitive mental score of all participants was above 18 (according to Mini-Mental State Examination). If they had another stroke during the following-up period, they were excluded from the study. Intraclass Correlation Coefficient (ICC), Standard Error of Measurement (SEM) and Minimum Detectable Change (MDC) were calculated to investigate the reliability of the KI. Criterion validity of the KI was assessed by Spearman’s Correlation Coefficient (ρ). Moreover, Confirmatory Factor Analysis (CFA) and Exploratory Factor Analysis (EFA) were performed to investigate the construct validity of the KI. Results: Inter-rater and intra-rater reliability of Persian Katz Index were reasonable (ICC2,1=0.93, ICC2,1=0.83; respectively). Internal consistency of this index was high (cronbach’s alpha=0.79). The high to excellent correlation was found between Katz Index and the motion (ρ=0.88), self-care (ρ=0.98), and total scores (ρ=0.92) of Barthel Index. Factor analysis of the Persian Katz Index indicated two factors including motion (bathing, toileting, and transferring) and self-care (dressing, bowel & bladder control, and feeding). Conclusion: The results of this study suggest that Persian version of Katz Index in patients with acute stroke can be considered as an acceptable clinical instrument in practice and research.

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BackgroundAlthough anxiety is a common non-motor outcome of Parkinson's disease (PD) affecting 40% of patients, little attention has been paid so far to its effects on balance impairment and postural control. Improvement of postural control through focusing on the environment (i.e. external focus) has been reported, but the role of anxiety, as a confounding variable, remains unclear.ObjectivesThis study aimed to investigate the influence of anxiety and attentional focus instruction on the standing postural control of PD patients.MethodsThirty-four patients with PD (17 with high anxiety (HA-PD) and 17 with low anxiety (LA-PD)), as well as 17 gender- and age-matched healthy control subjects (HC) participated in the study. Postural control was evaluated using a combination of two levels of postural difficulty (standing on a rigid force plate surface with open eyes (RO) and standing on a foam surface with open eyes (FO)), as well as three attentional focus instructions (internal, external and no focus).ResultsOnly the HA-PD group demonstrated significant postural control impairment as compared to the control, as indicated by significantly greater postural sway measures. Moreover, external focus significantly reduced postural sway in all participants especially during the FO condition.ConclusionThe results of the current study provide evidence that anxiety influences balance control and postural stability in patients with PD, particularly those with high levels of anxiety. The results also confirmed that external focus is a potential strategy that significantly improves the postural control of these patients. Further investigation of clinical applicability is warranted towards developing effective therapeutic and rehabilitative treatment plans.