Proposing the stroke levity scale: a valid, reliable, simple, and time-saving measure of stroke severity

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Abstract

Background and purpose

National Institutes of Health Stroke Scale (NIHSS) is long and complex. Our objective was to design a valid, reliable, simple, and time-saving stroke severity scale.

Methods

About 103 and 100 consecutive stroke patients in Berlin (Germany) and Ibadan (Nigeria), respectively were evaluated using the measures listed below. The Stroke Levity Scale (SLS) was calculated as maximum power (0–5) in the dexterous hand + maximum power in the weaker lower limb + mobility score−1(if aphasia present).

Results

It took less than 2 min to administer the SLS in contrast to 8 min for the NIHSS. The SLS showed significant correlation to the NIHSS (ρ = −0.79, P< 0.0001), the modified Rankin Scale (ρ = −0.79, P< 0.0001), and the health-related quality of life (QOL) in stroke patient's questionnaire (ρ = 0.78, P< 0.0001). It had Cronbach's α of 0.75 (Ibadan) and 0.71 (Berlin). The κ-value for test-retest reliability was 0.77 with P< 0.0001.

Conclusions

The SLS is a concise, valid, and reliable stroke impairment scale that can be used routinely to monitor outcome in stroke patients. Because it is brief and simple to apply, non-neurologists can be taught to administer it in addition to QOL and disability scales for stroke survivors without significantly increasing the respondent burden.

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