Stroke Outcome Measures Overview
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Type | Name | Approx time to administer | Strengths | Weaknesses | |
Level of consciousness | Glasgow Coma Scale | 2 minutes | Simple, valid, reliable. | None observed. | |
Stroke deficit scales | NIH Stroke Scale | 2 minutes | Brief, reliable, can be administered by non-neurologists. | Low sensitivity. | |
Canadian Neurological Scale | 5 minutes | Brief, valid, reliable. | |||
Global disability scale | Rankin Scale | 5 minutes | Good for overall assessment of disability. | Walking is the only explicit assessment criterion. Low sensitivity. | |
Measures of disability/activities of daily living (ADL) | Barthel Index | 5-10 minutes | Widely used for stroke. Excellent validity and reliability. | Low sensitivity for high-level functioning. | |
Functional Independence Measure (FIM) | 40 minutes | Widely used for stroke. | Measures mobility, ADL, cognition, functional communication. | “Ceiling” and “floor” effects. | |
Mental status screening | Folstein Mini-Mental State Examination | 10 minutes | Widely used for screening. | Several functions with summed score. May misclassify patients with aphasia. | |
Neurobehavioral Cognition Status Exam (NCSE) | 10 minutes | Predicts gain in Barthel Index scores. Unrelated to age. | Does not distinguish right from left hemisphere. No reliability studies in stroke. No studies of factorial structure. Correlates with education. | ||
Assessment of motor function | Fugl-Meyer | 30-40 minutes Extensively evaluated measure. | Good validity and reliability for assessing sensorimotor function and balance. | Considered too complex and time-consuming by many. | |
Motor Assessment Scale | 15 minutes | Good, brief assessment of movement and physical mobility. | Reliability assessed only in stable patients. Sensitivity not tested. | ||
Motricity Index | 5 minutes | Brief assessment of motor function of arm, leg, and trunk. | Sensitivity not tested. | ||
Balance assessment | Berg Balance Assessment | 10 minutes | Simple, well established with stroke patients,
sensitive to change. |
None observed. | |
Rivermead Mobility Index | 5 minutes | Valid, brief, reliable test of physical mobility. | Sensitivity not tested. | ||
Assessment of speech and language functions | Boston Diagnostic & Aphasia Examination | 1-4 hours | Widely used, comprehensive, good standardisation data, sound theoretical rationale. | Time to administer long; half of patients cannot be classified. | |
Porch Index of Communicative Ability (PICA) | 1/2-2 hours | Widely used, comprehensive, careful test development and standardisation. | Time to administer long. Special training required to administer. Inadequate sampling of language other than one word and single sentences. | ||
Western Aphasia Battery | 1-4 hours | Widely used, comprehensive. | Time to administer long. “Aphasia quotients” and “taxonomy” of aphasia not well validated. | ||
Depression scales | Beck Depression Inventory (BDI) | 10 minutes | Widely used, easily administered. Norms available. Good with somatic symptoms. | Less useful in elderly and in patients with aphasia or neglect.High rate of false positives. Somatic items may not be due to depression. | |
Center for Epidemiologic Studies Depression (CES-D) | < 15 minutes | Brief, easily administered, useful in elderly, effective for screening in stroke population. | Not appropriate for aphasic patients. | ||
Geriatric Depression Scale (GDS) | 10 minutes | Brief, easy to use with elderly, cognitively impaired, and those with visual or physical problems or low motivation. | High false negative rates in minor depression. | ||
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