Development of a prognostic scale for severely hemiplegic stroke patients in a rehabilitation hospital

Clinical Neurology and Neurosurgery
Yoshitake HiranoHiroshi Kigawa

Abstract

For patients with severe hemiplegia in a rehabilitation hospital, early prediction of the functional prognosis and outcomes is challenging. The purpose of this study was to create and verify a prognostic scale in severely hemiplegic stroke patients and allowing for prediction of (1) the ability to walk at the time of hospital discharge, (2) the ability to carry out activities of daily living (ADL), and (3) feasibility of home discharge. The study was conducted on 80 severely hemiplegic stroke patients. A prognostic scale was created as an analysis method using the following items: mini-mental state examination (MMSE) at the time of admission, modified NIH stroke scale (m-NIHSS); trunk control test (TCT); and the ratio of the knee extensor strength on the non-paralyzed side to the body weight (KES/BW-US). We verified the reliability and validity of this scale. We established a prognostic scale using the MMSE, m-NIHSS, TCT, and KES/BW-US. A score of 56.8 or higher on the prognostic scale suggested that the patient would be able to walk and that assistance with ADL would be unnecessary at the time of hospital discharge. In addition, a score of 41.3 points indicated that the patient's return home was feasible. The reliability and t...Continue Reading

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