This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Lyden, P. D. Articles by Lau, G. T. Search for Related Content PubMed PubMed Citation Articles by Lyden, P. D. Articles by Lau, G. T.

Stroke, Vol 22, 1345-1352, Copyright © 1991 by American Heart Association

ARTICLES

A critical appraisal of stroke evaluation and rating scales

PD Lyden and GT Lau
Department of Neurosciences, UCSD School of Medicine, La Jolla 92093- 0608.

BACKGROUND: To judge the efficacy of new, putative stroke therapies, we need a method to measure neurological deficit accurately in groups of patients before and after treatment. No single measurement technique has yet proven to be universally acceptable, but one approach is the use of rating instruments that summarize the neurological deficit found on clinical examination. Currently, stroke assessment scales may be based on the examination of physical deficits, an inventory of activities of daily living, or a global evaluation of functional outcome. SUMMARY OF REVIEW: Scientific methods for authenticating stroke scales are available in the psychometric and statistical literature. We review currently available stroke scales for their validity and reliability and propose investigations needed to refine further the standardized measurement of neurological deficit following stroke. CONCLUSIONS: We suggest that clinical stroke trials include a physical deficit scale and a global rating during the acute phase and that an activities of daily living scale be added at later points in recovery.

This article has been cited by other articles:

				N. Yozbatiran, L. Der-Yeghiaian, and S. C. Cramer A Standardized Approach to Performing the Action Research Arm Test Neurorehabil Neural Repair, February 1, 2008; 22(1): 78 - 90. [Abstract] [PDF]

				S. K. Schiemanck, G. Kwakkel, M. W. M. Post, and A. J. H. Prevo Predictive Value of Ischemic Lesion Volume Assessed With Magnetic Resonance Imaging for Neurological Deficits and Functional Outcome Poststroke: A Critical Review of the Literature. Neurorehabil Neural Repair, December 1, 2006; 20(4): 492 - 502. [Abstract] [PDF]

				F. B. Young, C. J. Weir, K. R. Lees, and for the GAIN International Trial Steering Committe Comparison of the National Institutes of Health Stroke Scale With Disability Outcome Measures in Acute Stroke Trials Stroke, October 1, 2005; 36(10): 2187 - 2192. [Abstract] [Full Text] [PDF]

				D. L. Tirschwell, W.T. Longstreth Jr, K. J. Becker, R. E. Gammans Sr, L. A. Sabounjian, S. Hamilton, and L. B. Morgenstern Shortening the NIH Stroke Scale for Use in the Prehospital Setting Stroke, December 1, 2002; 33(12): 2801 - 2806. [Abstract] [Full Text] [PDF]

				D. L. Tirschwell and W.T. Longstreth Jr Validating Administrative Data in Stroke Research Stroke, October 1, 2002; 33(10): 2465 - 2470. [Abstract] [Full Text] [PDF]

				B. C. Meyer, T. M. Hemmen, C. M. Jackson, and P. D. Lyden Modified National Institutes of Health Stroke Scale for Use in Stroke Clinical Trials: Prospective Reliability and Validity Stroke, May 1, 2002; 33(5): 1261 - 1266. [Abstract] [Full Text] [PDF]

				G. W. Albers, L. B. Goldstein, D. Hall, L. M. Lesko, and for the Aptiganel Acute Stroke Investigators Aptiganel Hydrochloride in Acute Ischemic Stroke: A Randomized Controlled Trial JAMA, December 5, 2001; 286(21): 2673 - 2682. [Abstract] [Full Text] [PDF]

				F. Gotoh, Y. Terayama, and T. Amano Development of a Novel, Weighted, Quantifiable Stroke Scale: Japan Stroke Scale Stroke, August 1, 2001; 32(8): 1800 - 1807. [Abstract] [Full Text] [PDF]

				NINDS Effect of Intravenous Recombinant Tissue Plasminogen Activator on Ischemic Stroke Lesion Size Measured by Computed Tomography Stroke, December 1, 2000; 31(12): 2912 - 2919. [Abstract] [Full Text] [PDF]

				A. W. Dromerick, D. F. Edwards, and M. Hahn Does the Application of Constraint-Induced Movement Therapy During Acute Rehabilitation Reduce Arm Impairment After Ischemic Stroke? Stroke, December 1, 2000; 31(12): 2984 - 2988. [Abstract] [Full Text] [PDF]

				P. W. Duncan, H. S. Jorgensen, and D. T. Wade Outcome Measures in Acute Stroke Trials : A Systematic Review and Some Recommendations to Improve Practice Stroke, June 1, 2000; 31(6): 1429 - 1438. [Abstract] [Full Text] [PDF]

				P. Lyden, M. Lu, C. Jackson, J. Marler, R. Kothari, T. Brott, and J. Zivin Underlying Structure of the National Institutes of Health Stroke Scale : Results of a Factor Analysis Stroke, November 1, 1999; 30(11): 2347 - 2354. [Abstract] [Full Text] [PDF]

				R. Ramasubbu, R. G. Robinson, A. J. Flint, T. Kosier, and T. R. Price Functional Impairment Associated With Acute Poststroke Depression: The Stroke Data Bank Study J Neuropsychiatry Clin Neurosci, February 1, 1998; 10(1): 26 - 33. [Abstract] [Full Text]

				L. D'Olhaberriague, I. Litvan, P. Mitsias, and H. H. Mansbach A Reappraisal of Reliability and Validity Studies in Stroke Stroke, December 1, 1996; 27(12): 2331 - 2336. [Abstract] [Full Text]

				M. Weinrich, S. Armentrout, and J. Reggia A Neural Model of Recovery from Lesions in the Somatosensory System Neurorehabil Neural Repair, January 1, 1995; 9(1): 25 - 32. [Abstract] [PDF]

				P. Gompertz, P. Pound, and S. Ebrahim Validity of the extended activities of daily living scale Clinical Rehabilitation, November 1, 1994; 8(4): 275 - 280. [Abstract] [PDF]