CCAC Case Manager Outcome Measures Interpretation Resource Stroke Network of Southeastern Ontario

Outcome Measurement Tool Items Measured Score Interpretation

MOTOR

Berg Balance Scale Balance - static and dynamic Scores of less than 45 out of 56 indicative of balance impairment

7 point quantitative scale- 1=total assist; 7=complete independence; Version 7 max score 49 (7 elements); Version 8 Chedoke Arm and Hand Activity Inventory (CAHAI) arm and hand function/ability max score 56 (8 elements); Version 9 max score 63 (9 elements) Version 13 max score 91 (13 elements)

Chedoke-McMaster Stroke Assessment U/E Upper extremity motor impairment Scale 1-7 - 1=flaccid paralysis; 7=normal

Chedoke-McMaster Stroke Assessment L/E Lower extremity motor impairment Scale 1-7 - 1=flaccid paralysis; 7=normal Score range 13-91 - higher score denotes greater mobility and COVS - Clinical Outcome Variable Score General functional mobility function Modified Ashworth Scale Spasticity Scale 0-4 - 0=no increase tone; 4=rigid in flexion or extension Overall score out of 48; performance criterion 0-6 0=simple; Motor Assessment Scale (Motor Learning every day motor function 6=complex; tonus 4=optimal - greater or less indicative of Nine Hole Peg Test arm and hand function/ability - fine manual dexterity timed - lower scores = better fine manual dexterity Timed "Up and Go" Test Mobility and balance relative to walking and turning timed - lower scores better distance measure - greater distance denotes better Six-Minute Walk Test Mobility and exercise tolerance performance; duration of rests measured

COGNITION / PERCEPTION Total score 227, with higher scores indicative of greater neglect - Behavioural Inattention Test inattention; unilateral visual neglect neglect indicated at 196 cutoff or greater Evaluates errors, omissions and distortions; Poor performance Visuospatial and praxis abilities; may detect deficits in Clock Draw Test correlates highly with poor performance on other cognitive attention and executive functioning screens Five Minute Protocol from the MoCA Cognitive Screening Pass/Fail Screening Deviation of 6mm or more indicative of unilateral spatial Line Bisection Unilateral spatial neglect, inattention neglect; or patient omits two or more lines on one half of the page Total score 30; 23 or less indicative of presence of cognitive Mini Mental Screening Exam (MMSE) Cognitive Screening impairment; levels of impairment 24-30=none; 18-24=mild; 0- 17=severe total score 30; 26 or less denotes screen failure; +1 score for Montreal Cognitive Assessment (MoCA) Cognitive Screening education

Motor-Free Visual Perception Test (MVPT) Visual perceptual screen, concentration, memory, good for Score out of 36; cutoff 30; poor MVPT scores predictive of poor patients with Aphasia driving outcome

Ontario Society OT Perceptual Evaluation - OSOT Perception Standardized for use with individuals aged 40-69 years

COMMUNICATION Apraxia Battery for Adults Presence and severity of apraxia of speech Refer to SLP with indications of apraxia

Boston Diagnostic Aphasia Assessment Auditory and reading comprehension; verbal and written Percentiles; percentages; standard scores M=100, range 85-115, expression; to diagnose aphasia; within normal limits

Boston Naming Test Anomia - evaluates word finding and vocabulary percentage correct score; total score out of 60

Frenchay Aphasia Screening Test (FAST) Aphasia screening tool for non-SLPs Pass/fail screen. If fail, refer to SLP for Assessment

Frenchay Dysarthria Assessment Speech intelligibility; oral motor weakness Refer to SLP with indications of dysarthria Language Screening Test (LAST) Aphasia screening tool for non-SLPs Pass/fail screen. If fail, refer to SLP for Assessment

Western Aphasia Battery Auditory and reading comprehension; verbal and written Criterion cut off scores based on identified quotients expression AQ - 0-25 very severe; 26-50 severe; 51-75 moderate; 76-85 mild.

EMOTION Brief Assessment Schedule Depression Cards Pass/fail screen. If fail, refer to SW for Assessment - <7 = risk of Depression; good for patients with Aphasia (BASDEC) depression. Total score 42, higher scores indicate greater anxiety and Hospital Anxiety/Depression Scale (HADS) Depression and anxiety depression; 14 items each valued at 0-3; 0=absent, 3=extreme presence.

FUNCTIONAL INDEPENDENCE Abbreviated FIM - 6 items - eating, Grooming, Bowel AlphaFIM Functional independence Management, Transfers: Toilet, Expression, and Memory

Functional Independence Measure (FIM) Functional independence; all domains; physical and Summed score of 18-126 with 18 being total dependence and cognitive disability in terms of burden of care 126 total independence

Inter RAI Functional independence; all domains Assesses 12 domains; determinations for 'at risk'

DYSPHAGIA AND NUTRITION SLP clinical assessment; validity maximized when paired with Bedside Evaluation of Dysphagia (BED) Dysphagia Clinical Assessment instrumental assessment VFSS

Dysphagia Screening - STAND Dysphagia screening tool Pass / Fail screen. If fail, refer to SLP Pass / Fail screen. If fail, refer to RD < 7/14 on screen = Fail Mini Nutritional Assessment Nutrition Screening Tool <17/30 on Full version = Fail/malnourished

Dysphagia Screening - TORBSST Dysphagia screening tool Pass / Fail screen. If fail, refer to SLP

See http://strokengine.ca/assess/index-en.html for more information on any of these Outcome Measurement Tools Rev. March 2013