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Determining cut-off points in functional assessment scales in stroke
Mercè Balasch i Bernat1, Sebastiá Balasch i Parisi2, Enrique Noé Sebastián3
1Department of Physiotherapy, Universidad de Valencia, Valencia, Spain.
Neurorehabilitation
|October 21, 2015
Summary
This study determined cut-off points for the Barthel Index (BI), Functional Independence Measure (FIM), and Functional Assessment Measure (FAM) to classify disability in stroke survivors. These cut-offs aid clinicians in interpreting patient independence and functional levels.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biostatistics
Background:
- Numerous validated scales assess functioning and disability in stroke patients.
- Existing instruments often present interpretation challenges.
- Establishing precise cut-off points is crucial for accurate disability categorization.
Purpose of the Study:
- To define critical cut-off points for the BI, FIM, and FAM scales.
- To differentiate distinct clinical disability categories in stroke survivors.
- To investigate the correlation between the modified Rankin Scale (mRS) and Disability Outcome Scale (DOS).
Main Methods:
- Recruitment of 106 adult stroke patients from a rehabilitation facility.
- Utilized the BI, FIM, FAM, mRS, and DOS assessment scales.
- Statistical analysis to determine scale correlations and cut-off points.
Main Results:
- A significant correlation was found between the DOS and mRS scales (Kendall's tau-b = 0.475, p < 0.001).
- Specific cut-off points were identified for BI (62.90, 21.30), FIM (70.62, 38.29), and FAM (116.07, 66.02) to delineate disability levels.
- The DOS scale was found to be more stringent regarding patient independence compared to the mRS.
Conclusions:
- The study successfully established cut-off points for the BI, FIM, and FAM, aiding in the interpretation of disability.
- Lower cut-off values were determined for distinguishing severe from moderate disability across the BI, FIM, and FAM.
- These findings enhance clinical utility for assessing and categorizing functional status in post-stroke individuals.
