Neuro Outcome measures Flashcards
The rivermead motor assessment
Stroke
Assesses functional mobility following stroke, including gait, balance, and transfers.
Composed of three sections: Gross function, Leg & Trunk, and Arm function.
Evaluates tasks like walking with/without an aid, standing on one leg, and bouncing a ball
Primarily relates to Activity and Body Functions (movement and function).
Takes approximately 45 minutes to administer and requires a variety of equipment for different functional tasks.
Assesses functional mobility post-stroke.Useful for tracking progress in rehabilitation and assessing motor recovery.
Test-Retest Reliability: Good to excellent, especially for lower limb and arm function.
Concurrent Validity: Strong correlation with other established measures of functional mobility.
National insitute of health stroke scale
Stroke
- A 15-item scale assessing the severity of impairments following a stroke.
- Evaluates factors such as consciousness, motor function, sensory loss, aphasia, and limb ataxia.
-Graded on a 3- or 4-point ordinal scale, with scores ranging from 0 to 42. - Higher scores indicate greater severity
Primarily relates to Body Functions and Body Structures (neurological function and sensory/motor deficits).
Takes approximately 6 minutes to administer and requires trained assessors to ensure reliability.
Administered to adults aged 18-64, especially in acute stroke settings
Measures the severity of stroke-related impairments.
Useful for early prognostication and monitoring stroke recovery.
Helps predict patient outcomes, particularly when combined with MRI findings
Test-Retest Reliability: Excellent
Inter-Rater Reliability: Excellent
Predictive Validity: Strong ability to predict stroke outcomes
Stroke specific QOL
Stroke
A patient-reported outcome measure with 49 items across 12 domains (mobility, energy, mood, social/family roles).
Relates to Body Functions & Structures, Activities, and Participation.
Takes approximately 10-15 minutes to complete.No training required for patient or therapist.
Measures quality of life post-stroke across multiple dimensions (e.g., mobility, social roles, emotional well-being). Sensitive to changes in health and quality of life during rehabilitation.
Reliability: Good internal consistency across most domains, with excellent test-retest reliability.
Validity: Strong construct validity, correlates well with other quality of life measures.
Sensitivity: Effective in detecting changes in quality of life over time.
Falls efficacy scale
Applicable to all
A 16-item questionnaire where individuals rate their concern about falling during various activities on a four-point Likert scale (1 = Not at all concerned to 4 = Very concerned).
Total score ranges from 16 to 64, with higher scores indicating greater fear of falling (FOF).
Activity and Participation.
Takes 5-10 minutes to complete.
No training required for patient or therapist.
Measures the level of fear of falling (FOF) during various everyday and social activities. Useful in assessing individuals at risk of falling, especially in elderly populations or those with mobility impairments.
Reliability: Good content and face validity, ensuring relevance across cultural contexts.
Validity: Strong content and face validity; developed by experts to ensure cross-cultural applicability.
Sensitivity: Effective in identifying fear of falling, often used in fall prevention interventions.
UPDRS
Parkinons
Scale used to measure the severity and progression of severity and progression of PD in patients. Consists of 6 segments.
Mood
ADL
Motor
Complication
Hoehn and Yahr scale
ADL scale
Primarily looking at body structure and function, with activities.
To monitor the response to medications, useto decreases signs and symptoms in PD.
Helps track progression
Higher scores indicate more severity
Excellent internal consistency and reliability
Valid and aligns with clinical observations
And changes to match improvements and decline
PDQ - 39
Parkinons
A 39 item self-report questionnaire, which assesses Parkinson disease specific health related quality over the last month
Assesses how often patients experience difficulties across the 8 quality of life dimensions
Mobility, ADLs, Emotional wellbeing, Stigma, Social support, cognition, communication, bodily discomfort.
Participation – QOL measures
Assesses QOL
Diseases progression
Treatment evaluation
Good internal consistency and reliability good test-retest
High validity, developed by experts
And changes to match improvements and decline
Tragus to wall
Parkinons
To objectively measure the cervical mobility of an individual.
Body structure and Function
Can be measured cued to stand straight or at baseline. Measure from the tragus to the wall.
For individuals with a flexed head and neck posture such as PD.
Excellent inter-tester reliability
Simple, reliable and valid
Multiple sclerosis impact scale
MS
Is a self-reported questionnaire designed to assess the psychological impact on MS in a person’s daily life.
Subsections of physical impact and psychological impact, it captures how MS affects a person’s ability to engage in life roles and emotional wellbeing.
Higher scores indicate greater impact on QOL
Participation
Under 10
self administered
no training
Measuring impact on MS on daily life
Tracking disease progression
Treatment effectiveness
Predicting participation levels
excellent test-retest reliability
It has strong validity. Show’s a strong correlation expanded disability status scale.
Moderate correlation with other QOL scales.
Detects meaningful changes in a patient’s condition
9 hole peg test
Applicable to all
A standardized, quantitative test measuring finger dexterity and upper limb function. The individual places and removes 9 pegs into a board as fast as possible; performance is timed.
Body Structure and Function (fine motor control) and Activity (manual task performance).
Assessing manual dexterity and upper limb function
Monitoring disease progression or motor recovery
Applicable for various populations: Stroke, Parkinson’s, MS, Pediatrics, and others
Excellent test-retest reliability and inter-rater reliability
Normative data available (e.g. <18s for healthy adults; >33s indicates severe impairment in MS)
Sensitive to functional change over time
MS walking scale 12
MS
A 12-item multiple sclerosis walking scale is a self-report measure oof the impact of MS on the individual’s walking ability.
It includes 12 items that assess walking limitations such as speed balance, distance, effort and use of support
Activity and participation
Evaluating walking limitations
Track changes in mobility over time
Identify walking related difficulty
Can be used alongside 25-foot walk test for complete picture
Reliability: High internal consistency (Cronbach’s alpha > 0.95) and excellent test-retest reliability.
Validity: Strong construct and concurrent validity — correlates well with both objective gait measures and other MS disability scales.
Responsiveness: Sensitive to changes following rehab or disease progression.
Fatigue severity scale
The 9-item scale which measures the severity of fatigue and its effect on a person’s activities and lifestyle in patients with a variety of disorders.
Looks at AODL, Life participation and sleep
Activity and participation
MS, PD and Stroke
Indicates clinically important change
Quantifies perceived fatigue severity
Used for monitoring changes in fatigue Functional limitations due to fatigue
Reliability: Excellent internal consistency (Cronbach’s alpha ~0.89); strong test-retest reliability.
Validity: Good construct and concurrent validity—correlates well with other fatigue and QOL measures.
Responsiveness: Sensitive to changes over time and following interventions.
Modified Ashworth scale
Stroke, MS, SCI
Used to measure spasticity in individuals with neurological conditions. Helps to assess resistance to passive movement due to increased muscle tone.
Seen in Stroke, Spinal cord injury and MS.
Body structure and Function
1-2 mins per limb
Basic clinical training
To quantify the severity of spasticity by grading the muscles resistance to passive stretch.
It helps track changes over time or in response to interventions
Guides rehabilitation
Reliability: Moderate inter-rater reliability; better when the same clinician performs repeated measures.
Validity: Limited in differentiating spasticity from soft tissue stiffness or contractures—should be used alongside other assessments.
Spinal cord independance measure
SCI
The SCIM assesses traumatic and non-traumatic, acute and chronic spinal cord injury – patient reported
ADL’s, Coordination, Eating, functional mobility, incontinence
Self-care, respiration and sphincter management, mobility
Designed to assess the functional independence of individuals with SCI – Real world abilities that are critical to daily life
Activity and participation
30 mins to 1hr
Some training
Tracking functional recovery
Treatment effectiveness
Guiding goal setting and care planning
High reliability: Good inter-rater and test-retest reliability
Strong validity: Sensitive to changes in function, even in small but meaningful gains
Responsiveness: Especially in the subacute and chronic phases of SCI
Walking index for spinal cord injury II
Assess the amount of physical assistance needed, as well as devices required, for walking following paralysis that results fromSpinal CordInjury (SCI). They are designed to be a more precise measure of improvement in walking ability specific to SCI.
Used to assess functional mobility and gait. Using a 20-point scale
Considers the amount of assistance and braces for a pt to walk over 10 meters
Activity
5 mins
No training
Evaluating walking capacity in individuals with incomplete SCI.
Monitoring recovery and determining assistive devise needs in rehab settings
Track functional improvements over time
Excellent reliability
Strong validity, aligns with the SCIM, 10MWT and balance measures
Responsive to rehab changes
ASIA
The ASIA impairment scale classifies motor and sensory impairments that result from SCI
is a standardized assessment used to classify the severity and level of spinal cord injuries. It includes Sensory examination, Motor examination, neurological, Completeness of injury
The ASIA is then graded on A-E
Body structure and function
Classifying SCI severity
Guiding prognosis and treatment planning
Tracking recovery over time
Inclusion criteria for rehab
High interrater reliability when performed by trained clinicians
Widely validated and internationally accepted
Excellent clinical utility
Berg balance Scale
Is a 14-item objective measure that assesses static balance and fall risk in adults
Non vestibular balance, and functional mobility, items scored 0-4 depending on ability
Tasks include sitting to standing, turning, reaching, standing on one foot, etc.
Activity
Stopwatch
Chair
Stool
Ruler
Shoe
Ruler
15-20 mins
Can be used for MS, PD, SCI, Stroke
Evaluating fall risk
Monitoring balance changes over time Setting goals
Excellent reliability (ICC > 0.95)
High internal consistency
Strong validity – correlates well with other balance and mobility measures (e.g., TUG, gait speed)
Cutoff score of ≤45 suggests increased fall risk in older adults and neuro populations
TUG
The TUG assesses mobility, balance, walking ability and fall risk
Pt sits in chair, at the command go, pt gets up walks 3 meters turns and sits back down.
Assessing mobility, balance, and fall risk
Commonly used in neurological conditions (e.g., stroke, Parkinson’s, MS, SCI), as well as in the elderly
Tracking functional changes over time
Fast and easy for clinical and community settings
Excellent reliability (ICC > 0.98)
Good validity – correlates with gait speed, BBS, and other functional tests
Responsive to changes post-rehabilitation
Minimal ceiling/floor effects – good across a wide range of function
Goal attainment scale
The Goal Attainment Scale (GAS) is an individualized outcome measure involving goal selection and goal scaling that is standardized to calculate the extent to which a patient’s goals are met.
The GAS is a flexible, individualized outcome measure used to track progress toward specific, patient-centred goals. Each goal is rated on a five-point scale, where:
+2 is much better than expected, +1 is somewhat better than expected, 0 is as expected, -1 is somewhat worse than expected, -2 is much worse than expected
It’s designed to evaluate the degree of goal achievement in a quantitative way based on the goals set by the patient and therapist.
Activity and participation
Training required
Non- specific patient poulation
Personalized goal setting
Measuring functional improvement
Tracking treatment effectiveness
Motivational tool
Good reliability (test-retest and inter-rater) when scoring is done according to structured procedures
Strong validity – reflects significant correlations with other established measures (like FIM, EQ-5D)
6 min walk test
The 6MWT evaluates functional capacitym measuring the disatnce a person can walk at a self selected pace over 6 mins.
Patients walk in a flat, straight line, typically 30 meters, total distance walked in 6 min recorded.
Body function and structure and activity
Cardiovascualr ftiness
functional mobility instroke MS SCI
monitioring progression or rehab
Excellent test retest
good interrater reliability
valid and correlates with other measures
