Stroke Outcome Measures: Recommended Flashcards
9 Hole Peg Test
ICF: Body function, activity
Clients take pegs from container 1 by 1, place them into holds as quickly as possible, then remove
Score based on time to complete, in seconds; OR # of pegs placed in 50 or 100 secs can be used
Cut-Off: Not established
MDC: 32.8 seconds, or 54% change
Action Research Arm Test
ICF: Activity
Assesses UE fx using observational methods
19 items, 4 sub-tests (grasp, grip, pinch, and gross movement)
3= performs normally 2= more time/difficulty 1= partially 0= can’t
First item most difficult, so if pt scores 3, remainder items scored as 3’s
Cut-Off: Not established
MDC: 3.0-3.5
MCID: 10% of measures total range or 5.7 pts
Arm Motor Ability Test
ICF: Activity
Evaluates disabilities in UE fx in ADL using quantitative and qualitative measures
13 ADL activities involving 1-3 component tasks or movement segments
Each task timed and rated according to quality of mov’t
Assessment of Life Habits
ICF: Activity, participation
Self-report Assesses 77 life habits from daily activities to social participation across 12 domains 2 scales (degree of difficulty and kind of assistance)
0-9 (9 no assistance, 0 not accomplished)
Cut-Off: Not established
MDC: Varies by domain, from 0.67 to 5.95
MCID: Not established
BESTest
ICF: Body structure, Fx, Activity
36-Item clinical balance assessment tool
Grouped into 6 systems (postural control: mechanical constraints, limits of stability, APAs, postural response, sensory orientation, and gait)
Total score of 108, calculated in to % score (0-100%)
Item level scores range from 0 (severe impairment) to 3 (no impairment)
Scored 1 category lower for items if they must use AD
Cut-Off:
» 69% differentiated fallers from non-fallers
» >49% in stroke indicates those with high functional ability
MDC: Subacute stroke: 7.91
MCID: Not Established
Box and Blocks Test
ICF: Activity
Assesses unilateral and gross manual dexterity
150 wooden cubes/blocks placed in one compartment or the other; move as many as possible 1 at a time for 60”
Count # of blocks; if multiple were carried over at once, only counts as 1 pt
Normative: decreases with age; ~80 in 40 yos
Cut-Off: Not established
MDC: 5.5 blocks per min
MCID: Not established
Chedoke-McMaster Stroke Assessment
ICF: Body fx, Activity
Also: TBI
Functional mobility assessment, observational, Assesses physical impairment and disability
Impairment inventory (6 dimensions): Recovery stage of arm, hand, leg, foot, postural control, shoulder pain
and Activity Inventory (gross motor function and walking subscale)
7 point scale for all
Impairment inventory: 6-42
Activity Inventory: Max score= 100, higher scores better
Cut-Off: >9 on leg and postural control scores indicate able to ambulate (I)’ly
MDC: Not established
MCID: Acute Stroke: 8 points
EuroQOL
ICF: Body structure, fx, participation
Questionnaire that measures 5 dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety/depression)
3 possible levels of problems (no, mild to moderate, and severe)
Modified Rankin Scale
ICF: Activity
Patient reported outcomes (self-report or interview) Categorizes level of functional independence w/reference to pre-stroke activities
All aspects of physical, mental performance, and speech combined into single MRS score:
0 no symptoms
1 No significant disability despite symptoms
2 Slight disability
3 Moderate disability, requiring some help
4 Moderately severe disability- unable to walk without assist, unable to ADL without assist
5 Severe disability- bedridden, totalA
Motricity Index
ICF: Body fx and structure
Ordinal method of measuring limb strength
Weighted scores developed to represent difficulty of progressing from one mm grade to next
6 items on each side (3 for UE, 3 for LE)
Max total limb score is 99
Rate of Perceived Exertion
ICF: Body fx
Used to determine intensity of exercise
15-point category scale w/ verbal descriptors
Scale: 6= rest
20= maximum
Parallels physiological variables
Rivermead Motor Assessment
ICF: Activity
Also: BI (though with large ceiling effect)
Performance-based measure
3 sections: gross function, leg and trunk, and arm
38 items
Score yes ‘1’ or no ‘0’
Stop at first no (though some studies say to test all items)
Cut-Off: Low RMA scores at 6 weeks predicted poor prognosis to ambulation
MDC: Not established
MCID: 3 pt change in total RMA score
SF-36
ICF: Body fx, activity, participation
36-item patient-reported measure aimed at quantifying health status, often used for QOL
Divided into 8 subscales and 2 composite domains (physical and mental)
Likert scale for each item
Items w/in subscales totaled, then summed score is linearly transformed onto scale from 0 to 100 (100 better)
Reporting re: last 4 weeks
Notes: +++floor effects for pts with SCI and other disabilities due to inability to perform physical tasks described
o Significant floor effects for pts with SCI
o Not recommended for pts who cannot understand written or spoken language
o SF-12 is shorter version with 12 items- covers summary physical health and mental health scales
• Beginning to be more commonly used in TBI population
o PD MDC for each subscale: ranges 19-45
Stroke-Adapted SIP-30 (Sickness Impact Profile)
ICF: Body fx, activity, participation, environment
Patient reported measure
30 items describing change in behavior that reflects impact of illness on aspect of daily like
8 subscales
Patients mark items as “yes” or “no”
Weights applied to each marked item, summed fo each subscale, and expressed as % of each subscale from 0-100
High= worse
Trunk Impairment Scale
ICF: Body structure, fx, activity
Measures motor impairment of stroke through eval of 3 subscales with 3-10 items each: static and dynamic sitting balance, and coord of trunk mov’t
Range 0-23
Each item can be performed 3 times, highest counts
