Institute for Clinical and Translational Science

Background and Purpose

Patient-reported outcome measures have been found useful in many disciplines but have received limited evaluation after stroke. The current study investigated the relationship that patient-reported measures have with standard impairment and disability scales after stroke.

Patients with motor deficits after stroke were scored on standard assessments including NIH Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Fugl-Meyer motor scale (FM), and on two patient-reported measures, the hand function domain of the Stroke Impact Scale (SIS), which documents difficulty of hand motor usage, and the amount of use portion of the Motor Activity Log (MAL), which records amount of arm motor usage.

The 43 participants had mild disability (median mRS=2), moderate motor deficits (FM=46 ± 22), and mild cognitive/language deficits. The two patient-reported outcome measures, SIS and MAL, were sensitive to the presence of arm motor deficits. Of 21 patients classified as having minimal or no impairment or disability by the NIHSS or mRS (score of 0-1), 15 (71%) reported difficulty with hand movements by the SIS score or reduced arm use by the MAL score. Furthermore, of 14 patients with a normal exam, 10 (71%) reported difficulty with hand movements or reduction in arm use.

Patient-reported measures were a unique source of insight into clinical status in the current population. Motor deficits were revealed in a majority of patients classified by standard scales as having minimal or no disability, and in a majority of patients classified as having no deficits.