Measurement Characteristics and Clinical Utility of the Executive Function Performance Test Among Individuals With Stroke

      Higher-level cognitive functions, such as decision-making, self-correction, and judgment, are referred to as executive functions. Following stroke, approximately two-thirds of individuals experience some impairment in cognitive function,1 which is associated with decreased ability to complete activities of daily living and instrumental activities of daily living, contributing to longer rehabilitation stays.2 Because of the impact these deficits have on independent living, assessment of executive function is critical to understanding the amount of support or assistance an individual requires in order to complete daily tasks. The Executive Function Performance Test (EFPT) is a performance-based measure that assesses impairments in executive function, including an individual's capacity to live independently and the amount of assistance needed to complete common tasks. Tasks assessed include: simple cooking, telephone use, medication management, and bill payment. The EFPT has demonstrated excellent reliability and adequate to excellent validity in individuals with stroke. Approximately 2 hours are required to complete the EFPT. The instrument's test booklet is free; however, the test kit costs approximately $50.
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the EFPT in stroke populations. For a full review of the EFPT, along with reviews of over 100 other instruments, go to
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      • 1
        Kalaria RN, Ballard C. Stroke and cognition. Curr Atheroscler Rep 2001;3:334-9.
      • 2
        Hinkle JL. Variables explaining functional recovery following motor stroke. J Neurosci Nurs 2006;38:6-12.
      • 3
        Baum C, Connor L, Morrison T, Hahn M, Dromerick A, Edwards D. Reliability, validity, and clinical utility of the executive function performance test: a measure of executive function in a sample of people with stroke. Am J Occup Ther 2008;62:446.
      • 4
        Wolf T, Stift S, Connor L, Baum C. Feasibility of using the EFPT to detect executive function deficits at the acute stage of stroke. Work 2010;36:405-12.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the United States Department of Education. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024).