The NIHSS supplementary motor scale: a valid tool for multidisciplinary recovery trials
Enrique C Leira1, Christopher S Coffey, Ricardo E Jorge
1Department of Neurology, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA.
Cerebrovascular Diseases (Basel, Switzerland)
|August 8, 2013
Summary
The Supplementary Motor Scale of the NIH Stroke Scale (SMS-NIHSS) effectively assesses motor recovery after stroke. This validated tool predicts functional outcomes and can be easily integrated into clinical trials for stroke rehabilitation.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Clinical Trials
Background:
- Growing interest in therapies to augment motor recovery post-stroke.
- Need for standardized clinicometrics in multidisciplinary stroke trials.
- The Supplementary Motor Scale of the NIH Stroke Scale (SMS-NIHSS) assesses upper and lower extremity motor function.
Purpose of the Study:
- To evaluate the SMS-NIHSS as a valid tool for motor recovery assessment.
- To determine the prognosticative value of the SMS-NIHSS in stroke patients.
- To assess the SMS-NIHSS's sensitivity to changes during recovery.
Main Methods:
- Analysis of SMS-NIHSS scores in 1,281 patients from the TOAST trial.
- Plotting probability of favorable (FO) and very favorable (VFO) outcomes based on baseline SMS-NIHSS.
- Multivariate logistic regression and Spearman correlation with Barthel Index (BI) and Glasgow Outcome Score (GOS).
Main Results:
- SMS-NIHSS scores improved from 8.18 at baseline to 4.68 at 3 months.
- Baseline SMS-NIHSS independently predicted FO and VFO at 3 months (p < 0.0001).
- SMS-NIHSS showed strong correlations with BI (r = -0.70) and GOS (r = 0.73) at 3 months.
Conclusions:
- The SMS-NIHSS is a valid and prognostic tool for assessing motor recovery post-stroke.
- The scale is sensitive to changes during the recovery period.
- Its integration into clinical trials is feasible due to its relation to the NIHSS.
