| Type
|
Name
|
Approx time to administer
|
Strengths
|
Weaknesses
|
| Level of consciousness
|
| Stroke deficit scales
|
NIH Stroke Scale
|
2 minutes
|
Brief, reliable, can be administered by non-neurologists.
|
Low sensitivity.
|
|
| 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)
|
|
| Mental status screening
|
Folstein
| 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.
|
|
| 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
|
| 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.
|
|
| Depression scales
|
|
| 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.
|
| Hamilton Depression Scale
|
|
Observer rated; frequently used in stroke patients.
|
Multiple differing versions compromise interobserver reliability.
|
| Measures of instrumental ADL
|
PGC Instrumental Activities of Daily Living
|
5-10 minutes
|
Measures broad base of information necessary for independent living.
|
Has not been tested in stroke patients.
|
| Frenchay Activities Index
|
10-15 minutes
|
Developed specifically for stroke patients; assesses broad array of activities.
|
Sensitivity and interobserver reliability not tested; sensitivity probably limited.
|
| Family assessment
|
Family Assessment Device (FAD)
|
30 minutes
|
Widely used in stroke. Computer scoring available. Excellent validity and reliability. Available in multiple languages.
|
Assessment subjective; sensitivity not tested; “ceiling” and “floor” effects.
|
| Health status/ quality of life measures
|
Medical Outcomes Study (MOS) 36-Item Short-Form Health Survey
|
10-15 minutes
|
Generic health status scale SF36 is improved version of SF20. Brief, can be self – administered or administered by phone or interview. Widely used in the United States.
|
Possible “floor” effect in seriously ill patients (especially for physical functioning), suggests it should be supplemented by an ADL scale in stroke patients.
|
| Sickness Impact Profile (SIP)
|
0-30 minutes
|
Comprehensive and well-evaluated. Broad range of items reduces “floor” or “ceiling” effects.
|
Time to administer somewhat long. Evaluates behavior rather than subjective health; needs questions on well-being, happiness, and satisfaction.
|
