Comparison of the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) and the Barthel Index in stroke patients

Abstract

Objective: To compare the responsiveness of the Utrecht Scale for Evaluation of Rehabilitation (USER) to the responsiveness of the Barthel Index in stroke patients in an inpatient rehabilitation facility. Design: Observational study. Setting: Inpatient rehabilitation facility. Subjects: Consecutive stroke patients admitted for clinical rehabilitation. Interventions: Not applicable. Main measures: The USER and the Barthel Index were administered by a nurse at admission and discharge. The Effect Size and Standardized Response Mean (SRM) were calculated as measures of responsiveness. Results: From 198 (78%) of the 254 patients who were included in the study period, both admission and discharge data were available. At admission the mean score of the USER subscale Functional independence was 43.1 ( SD = 18.9) and at discharge the mean score was 59.3 ( SD = 13.8). The mean score of the Barthel Index at admission was 13.3 ( SD = 5.4) and at discharge 18.4 ( SD = 3.3). The Effect Size of the USER subscales Mobility, Self-care, Cognitive functioning, Pain, Fatigue and Mood were 0.85, 0.77, 0.48, 0.19, 0.40 and 0.28, respectively, and of the Barthel Index 0.94. The results for the SRM were in the same range. Conclusion: In inpatient rehabilitation after stroke, the USER was less responsive than the Barthel Index.

Women With Cerebral Infarction Feature Worse Clinical Profiles at Admission but Comparable Success to Men During Long-Term Inpatient Neurorehabilitation

“…Therefore, the focus should be on early neurorehabilitation for all stroke patients and especially for women. Post-stroke loss to follow-up was reported from the national Austrian Acute Stroke Unit Registry as well as from Sweden with women being more likely to display ADL dependency, independent of stroke severity (Ullberg et al, 2016a;Willers et al, 2018). In another study, 22% of patients reported unmet rehabilitation needs at 12 months (Ullberg et al, 2016b).…”

“…Patients more often suffered from post-stroke depression and insufficient pain management; female sex was a predictor of worse outcomes (Ullberg et al, 2016b). Application and timing of rehabilitation depends on the health care providers as well as on the ability and willingness of the patients, and probably, on psychosocial determinants (Ullberg et al, 2016a). However, post-stroke ADL scores were consistently worse in women even after adjustment for psychosocial factors like education, medical insurance, and marital status (Lisabeth et al, 2015).…”

“…However, the exact causes remain unclear and most studies investigated the acute care setting. Studies on stroke-neurorehabilitation are few in number, refer to outdated standards of care or include only small cohorts ( Paolucci et al, 1998 ; van Meijeren-Pont et al, 2019 ). Despite inconsistent outcomes regarding the few analysis of differences between men and women ( Di Carlo et al, 2003 ; Kelly-Hayes et al, 2003 ; Paolucci et al, 2006 ; Ones et al, 2009 ; Petrea et al, 2009 ; Pohl et al, 2013 ; Caglar et al, 2014 ; Ullberg et al, 2015 ; Willers et al, 2018 ), women are reported to have a worse rehabilitation success ( Paolucci et al, 2006 ; Ullberg et al, 2015 , 2016b ) as well as a higher need for assistance and 3 fold higher admission rates to special care homes post-stroke in some studies ( Petrea et al, 2009 ).…”

Pan-European Study on Functional and Medical Recovery and Geriatric Rehabilitation Services of Post-COVID-19 Patients: Protocol of the EU-COGER Study

“…ADL functioning will be assessed with the Barthel Index, Utrecht Scale for the Evaluation of Rehabilitation (USER) or Functional Independence Measure (FIM), depending on use in the participating country. The USER (16) and FIM (17,18) will be converted afterwards to the Barthel Index using standardised approaches.…”

Responsiveness of the Spanish Version of Newcastle Stroke-Specific Quality of Life Measure (NEWSQOL)

“…The World Health Organization defines stroke as “the rapid onset of clinical symptoms of focal or global brain dysfunction, which lasts longer than 24 h or leads to death, with no other apparent cause than a vascular injury” [ 1 ]. The number of stroke patients around the world has increased considerably in recent decades [ 2 ], especially since the global pandemic started, where stroke arose as a complication of COVID-19, although up to now, its incidence remains unknown [ 3 , 4 ]. Clinical manifestations are wide and varied, including motor, sensory, perception and cognitive disturbances; urinary and faecal incontinence; swallowing and visual problems; and pain, communication and behavioural alterations [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 ].…”