From the Department of Preventive Medicine (S.-M.L., J.K.), and the
Center on Aging (P.W.D.), University of Kansas Medical Center, Kansas City;
the Department of Veteran Affairs Medical Center (P.W.D.), Kansas City, Mo;
and the Department of Health Services Research, University of Kansas,
Lawrence.
Correspondence to Sue-Min Lai, PhD, MS, MBA, Department of Preventive Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160-7313. E-mail smlai{at}kumc.edu
Background and Purpose—This study
compared the ability of 2 stroke impairment scales, Orpington
Prognostic Scale and National Institutes of Health (NIH) Stroke Scale,
to predict disability as measured by the Barthel activities of
daily living (ADL) Index and higher level of self-reported physical
functioning as measured by the SF-36 physical functioning index (PFI)
at 1, 3, and 6 months after stroke.
Methods—The participants in this ongoing study are 184
individuals who sustained an eligible stroke and were recruited for the
Kansas City Stroke Study. All patients were prospectively evaluated
using standardized assessments at enrollment (within 14 days of stroke
onset) and followed at 1, 3, and 6 months after stroke. Coefficient of
determination (R2) was used to assess the
ability of the 2 stroke scales to prognosticate outcomes.
Results—Means and SDs of the Orpington Prognostic Scale and NIH
Stroke Scale measured at baseline were 3.6±1.31 and 5.5±4.58,
respectively. The Spearman's rank correlation between the 2 baseline
measures was 0.83 (P=0.0001). The Orpington Prognostic
Scale and the NIH Stroke Scale explained well the variance in Barthel
ADL Index (P<0.001). However, the Orpington Prognostic
Scale explained more variance than did the NIH Stroke Scale. Similarly,
the Orpington Prognostic Score explained more variance in higher level
of physical function than did the NIH Stroke Scale. The amount of
variance in Barthel ADL Index and SF-36 PFI, which were explained by
both stroke severity measures, decreased over time.
Conclusions—Our results demonstrate that in a sample of mostly
mild and moderate strokes, the Orpington Prognostic Scale compared with
the NIH Stroke Scale is simpler to use and is a slightly better
predictor of ADL and higher levels of physical function.
© 1998 American Heart Association, Inc.
Original Contributions
Prediction of Functional Outcome After Stroke
Comparison of the Orpington Prognostic Scale and the NIH Stroke Scale
Key Words: activities of daily living • impairment • physical function • stroke
This article has been cited by other articles:
 |
|
 |
|
  S. F. Tyson, M. Hanley, J. Chillala, A. B. Selley, and R. C. Tallis Sensory Loss in Hospital-Admitted People With Stroke: Characteristics, Associated Factors, and Relationship With Function Neurorehabil Neural Repair, April 1, 2008; 22(2): 166 - 172. [Abstract] [PDF]
|
|
|
|
 |
|
 D. S Reisman and J. P Scholz Deficits in Surface Force Production During Seated Reaching in People After Stroke Physical Therapy, March 1, 2007; 87(3): 326 - 336. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. E Harris and J. J Eng Paretic Upper-Limb Strength Best Explains Arm Activity in People With Stroke Physical Therapy, January 1, 2007; 87(1): 88 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Schenkman, J. E Deutsch, and K. M Gill-Body An Integrated Framework for Decision Making in Neurologic Physical Therapist Practice Physical Therapy, December 1, 2006; 86(12): 1681 - 1702. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. M. Quaney, S. Perera, R. Maletsky, C. W. Luchies, and R. J. Nudo Impaired Grip Force Modulation in the Ipsilesional Hand after Unilateral Middle Cerebral Artery Stroke Neurorehabil Neural Repair, December 1, 2005; 19(4): 338 - 349. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Koyama, K. Matsumoto, T. Okuno, and K. Domen A new method for predicting functional recovery of stroke patients with hemiplegia: logarithmic modelling Clinical Rehabilitation, July 1, 2005; 19(7): 779 - 789. [Abstract] [PDF]
|
|
|
|
|
|
D. Meldrum, S. J Pittock, O. Hardiman, C. N. Dhuill, M. O'Regan, and J. T Moroney Recovery of the upper limb post ischaemic stroke and the predictive value of the Orpington Prognostic Score Clinical Rehabilitation, June 1, 2004; 18(6): 694 - 702. [Abstract] [PDF]
|
|
|
|
 |
|
 M. M. Ouellette, N. K. LeBrasseur, J. F. Bean, E. Phillips, J. Stein, W. R. Frontera, and R. A. Fielding High-Intensity Resistance Training Improves Muscle Strength, Self-Reported Function, and Disability in Long-Term Stroke Survivors Stroke, June 1, 2004; 35(6): 1404 - 1409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Kwon, A. G. Hartzema, P. W. Duncan, and S. Min-Lai Disability Measures in Stroke: Relationship Among the Barthel Index, the Functional Independence Measure, and the Modified Rankin Scale Stroke, April 1, 2004; 35(4): 918 - 923. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Performance of a Statistical Model to Predict Stroke Outcome in the Context of a Large, Simple, Randomized, Controlled Trial of Feeding Stroke, January 1, 2003; 34(1): 127 - 133. [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. J. Gladstone, S. E. Black, and A. M. Hakim Toward Wisdom From Failure: Lessons From Neuroprotective Stroke Trials and New Therapeutic Directions Stroke, August 1, 2002; 33(8): 2123 - 2136. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-M. Lai, S. Studenski, P. W. Duncan, and S. Perera Persisting Consequences of Stroke Measured by the Stroke Impact Scale Stroke, July 1, 2002; 33(7): 1840 - 1844. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. W. Duncan, D. Wallace, S. M. Lai, D. Johnson, S. Embretson, and L. J. Laster The Stroke Impact Scale Version 2.0 : Evaluation of Reliability, Validity, and Sensitivity to Change Stroke, October 1, 1999; 30 (10): 2131k - 2140. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Shafqat, J. C. Kvedar, M. M. Guanci, Y. Chang, and L. H. Schwamm Role for Telemedicine in Acute Stroke : Feasibility and Reliability of Remote Administration of the NIH Stroke Scale Stroke, October 1, 1999; 30(10): 2141 - 2145. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-M. Lai and P. W. Duncan Evaluation of the American Heart Association Stroke Outcome Classification Stroke, September 1, 1999; 30(9): 1840 - 1843. [Abstract] [Full Text] [PDF]
|
|