Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke

Lee, Seung Yeol; Kim, Deog Young; Sohn, Min Kyun; Lee, Jongmin; Lee, Sam Gyu; Shin, Yong Il; Kim, Soo Yeon; Oh, Gyung Jae; Lee, Young Ho; Lee, Yang Soo; Joo, Min Cheol; Lee, So Young; Ahn, Jae Youn; Chang, Won Hyuk; Choi, Ji Yoo; Kang, Sung Hyun; Kim, Il Yoel; Han, Junhee; Kim, Yun Hee

doi:10.1371/journal.pone.0226324

Cited by 58 publications

(59 citation statements)

References 31 publications

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“…Further, he suggested that a BI score ≧90 with mRS ≦2 to be the optimal cutoff score to define a favorable outcome (sensitivity: 90.7%, specificity: 88.1%) [ 16 ]. Recently, a study of 5,759 stroke patients found the optimal cutoff points of the Korean versions of the MBI (K-MBI) to be 98 (sensitivity: 90.4%; specificity 83.8%) and 94 (sensitivity: 88.5%; specificity: 93.7%) for mRS grades 1 and 2, respectively [ 19 ]. Our preliminary study found the optimal cutoff scores of BI to be 100 (sensitivity: 100%; specificity 95.3%) and 100 (sensitivity: 98.1%; specificity 100%) corresponding to the adjusted mRS 1 and 2, respectively [ 20 ].…”

Section: Discussionmentioning

confidence: 99%

Stroke outcome assessment: Optimizing cutoff scores for the Longshi Scale, modified Rankin Scale and Barthel Index

et al. 2021

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The Longshi Scale, a visual-based scale, is reliable and valid in activity assessment, but lacks cutoff definition corresponding to classical scales such as the modified Rankin Scale and Barthel Index. Therefore, this study aimed to investigate the relationships of the Longshi Scale with the modified Rankin Scale and Barthel Index and optimize cutoff scores of these scales in stroke outcomes assessment. This is a cross-sectional study. Stroke patients were measured concurrently by the Longshi scale, modified Rankin Scale and Barthel Index. Kruskal-Wallis test and Spearman correlation analysis were used to analyze the differences and associations among the three scales. The receiver operating characteristic curve was performed to determine the optimal cutoff scores. A total of 5475 stroke patients (67.3% ischemic) were included in this study. There are close relationships of the Longshi Scale with adjusted modified Rankin Scale and Barthel Index (r = -0.861, 0.922; p<0.001, <0.001; respectively). The activity levels assessed by adjusted modified Rankin Scale and Barthel Index among different Longshi scale grades were significantly different (χ2:4217.27, 4676.55; p<0.001, <0.001; respectively). The optimal cutoff scores were adjusted modified Rankin Scale 4, 3, 3, 3, 2 for Longshi scale grade 2 to 6 (sensitivity%: 96.12, 70.24, 89.10, 96.80, 86.23, specificity%: 72.72, 98.29, 93.81, 79.82, 92.89, respectively), and Barthel Index 15, 45, 60, 75, 80 for Longshi scale grade 2 to 6 (sensitivity%: 92.54, 89.28, 91.32, 90.30, 95.65, specificity%: 95.48, 89.51, 94.02, 90.41, 90.62, respectively). In conclusion, the classification of Longshi Scale is consistent with those of modified Rankin Scale and Barthel Index. We recommend the Longshi Scale as an effective supplement for modified Rankin Scale and Barthel Index in assessing the outcome in acute stroke patients.

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Section: Discussionmentioning

confidence: 99%

Stroke outcome assessment: Optimizing cutoff scores for the Longshi Scale, modified Rankin Scale and Barthel Index

et al. 2021

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“…Patient health questionnaire (9 and PHQ-9), modified Barthel (MBI) Patient Health Questionnaire-9 was a measure of depression and >4 diagnosed depression ( Levis et al, 2019 ). MBI is a common scale to measure daily living disability or dependence in stroke patients ( Lee et al, 2020 ), 0–100, the lower the score indicates the poor living ability At 1d before treatment and 8 weeks after treatment, the 5 ml, blood collection site of the two groups was fasting venous blood before the elbow, 1d, of serum was static placed at room temperature after anticoagulant, and the serum was taken for-80℃ freezing in the medical refrigerator The HPLC method is used ( Hirowatari and Yoshida, 2019 ). Determination of the patient serum monamines and amino acid neurotransmitters, including dopamine (dopamine, DA), norepinephrine (norepinephrine, NE), 5-serotamine (5-hydroxytruptamine,5-HT) and amino acid neurotransmitters including glutamate (glutamatem, Glu) and glycine (glycine, Gly).…”

Section: Methodsmentioning

confidence: 99%

Effect of transcranial magnetic stimulation on treatment effect and immune function

Liu

Wang

et al. 2022

Saudi Journal of Biological Sciences

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To explore the effect of transcranial stimulation on the therapeutic effect and immune function of patients with post-stroke depression (PSD). Methods Selection in September 2020–April 2021 on the diagnosis of 70 patients with PSD as the research object, 35 patients were randomly divided into control group and intervention group and control group given conventional treatment, the intervention group in the control group on the basis of the application of transcranial magnetic stimulation treatment, compare the curative effect of two groups of patients after the treatment cycle and the effects on the immune function. Results After treatment, the levels of DA, NE, 5-HT in 2 groups were significantly increased, and those in the observation group were significantly higher than those in the control group (P < 0.05). After 8 weeks of treatment, serum Gly content in 2 groups was significantly increased and Glu content was significantly decreased compared with before treatment. Compared with the control group, serum Gly content in observation group was significantly increased and Glu content was significantly decreased after treatment (P < 0.05). After 8 weeks of treatment, the contents of IL-1β, IL-6 and TNF-α in serum of 2 groups were significantly decreased, compared with the control group, the contents of IL-1β, IL-6 and TNF-α in serum of observation group were significantly decreased (P < 0.05); Before treatment, there was no significant difference in PHQ-9 score and MBI score between the two groups (P > 0.05). After 8 weeks of treatment, PHQ-9 score and MBI score in the two groups were better than before treatment, and the observation group was better than the control group (P < 0.05). Conclusion Transcranial magnetic stimulation therapy can not only effectively promote the synthesis and release of monoamine neurotransmitters in patients with post-stroke depression, regulate the inhibitory/excitatory amino acid neurotransmitters, reduce inflammatory response, improve the clinical treatment effect and enhance the immune function of PSD patients, which has clinical application value.

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“…Then, cognitive ability and functional capacity were assessed with the Montreal Cognitive Assessment (MoCA) [ 30 ] and the modified Rankin Scale (mRS) [ 31 ], respectively. Regarding the latter, most stroke trials define a favorable functional outcome as mRS grade ≤2 [ 32 ]. Therefore, we rated participants who scored ≤2 as “No disability or slight” and those who scored 3 to 5 as “Moderate or severe disability”.…”

Section: Methodsmentioning

confidence: 99%

Association of Barriers, Fear of Falling and Fatigue with Objectively Measured Physical Activity and Sedentary Behavior in Chronic Stroke

Sánchez-Sánchez

Arnal‐Gómez

Cortés‐Amador

et al. 2021

JCM

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Understanding the fostering factors of physical activity (PA) and sedentary behavior (SB) in post-stroke chronic survivors is critical to address preventive and health interventions. This cross-sectional study aimed to analyze the association of barriers to PA, fear of falling and severity of fatigue encountered by stroke chronic survivors with device-measured PA and SB. Ambulatory community-dwelling post-stroke subjects (≥six months from stroke onset) were evaluated and answered the Barriers to Physical Activity after Stroke Scale (BAPAS), Short Falls Efficacy Scale-International (Short FES-I) and Fatigue Severity Scale (FSS). SB and PA were measured with an Actigraph GT3X+ accelerometer for ≥seven consecutive days. Stepwise multiple linear regression analysis was employed to identify factors associated with PA and SB. Fifty-seven participants (58.2 ± 11.1 years, 37 men) met the accelerometer wear–time criteria (three days, ≥eight h/day). The physical BAPAS score explained 28.7% of the variance of the prolonged sedentary time (β = 0.547; p < 0.001). Additionally, the walking speed (β = 0.452) together with physical BAPAS (β = −0.319) explained 37.9% of the moderate-to-vigorous PA time (p < 0.001). In chronic post-stroke survivors, not only the walking speed but, also, the perceived physical barriers to PA are accounted for the SB and PA. Interventions to reverse SB and to involve subjects post-stroke in higher levels of PA should consider these factors.

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Determining the cut-off score for the Modified Barthel Index and the Modified Rankin Scale for assessment of functional independence and residual disability after stroke

Cited by 58 publications

References 31 publications

Stroke outcome assessment: Optimizing cutoff scores for the Longshi Scale, modified Rankin Scale and Barthel Index

Stroke outcome assessment: Optimizing cutoff scores for the Longshi Scale, modified Rankin Scale and Barthel Index

Effect of transcranial magnetic stimulation on treatment effect and immune function

Association of Barriers, Fear of Falling and Fatigue with Objectively Measured Physical Activity and Sedentary Behavior in Chronic Stroke

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