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Related Experiment Videos

Assessment of functioning and disability after ischemic stroke.

Christian Weimar1, Tobias Kurth, Klaus Kraywinkel

  • 1Department of Neurology, University of Essen, Essen, Germany.

Stroke
|August 3, 2002
PubMed
Summary

Assessing ischemic stroke outcomes is crucial. The modified Rankin Scale (MRS) and SF-36 Physical Functioning (SF-36 PF) are better than the Barthel Index (BI) to avoid ceiling effects in specialized stroke centers.

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Public Health.

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Area of Science:

  • Neurology
  • Clinical Research
  • Rehabilitation Medicine

Background:

  • Ischemic stroke significantly impacts patient functioning and disability.
  • Numerous instruments exist to assess stroke outcomes, but their interrelation and predictive factors are not well understood.

Purpose of the Study:

  • To investigate the interrelation and predictive factors of various outcome assessment scales after ischemic stroke.
  • To compare the effectiveness of different instruments in measuring stroke outcomes.

Main Methods:

  • Prospective identification of 4264 acute ischemic stroke patients from 30 German hospitals.
  • Centralized follow-up via telephone interview at 100 days and 1 year.
  • Assessment using Barthel Index (BI), modified Rankin Scale (MRS), extended Barthel Index (EBI), SF-36 Physical Functioning (SF-36 PF), and Center for Epidemiologic Studies-Depression (CES-D) scales.

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Main Results:

  • Outcome data assessed in 67.2% of patients at 100 days; 13.9% mortality.
  • Functional independence (BI <95) achieved by 53.7%, mild disability (MRS < or =1) by 46.3%.
  • 32.9% reported depressive symptoms (CES-D >=10); predictive factors varied for depression compared to functioning/disability.

Conclusions:

  • The modified Rankin Scale (MRS) and SF-36 Physical Functioning (SF-36 PF) are preferable to the Barthel Index (BI) to avoid ceiling effects in specialized stroke centers.
  • Parametric use of SF-36 PF can enhance outcome measurement by incorporating individual treatment effects.