Abstract
Background.
Stroke patients present restriction of mobility in the acute phase, and
the use of a simple and specific scale can be useful to guide
rehabilitation.
Objective. To validate and propose a Hospital
Mobility Scale (HMS) for ischemic stroke patients as well as to evaluate
the HMS as a prognostic indicator.
Methods. This study was
performed in 2 phases: in the first, we developed the HMS content, and
in the second, we defined its score and evaluated its psychometric
properties. We performed a longitudinal prospective study consisting of 2
cohorts (derivation and validation cohorts). The data were collected in
a stroke unit, and the following scales were applied during
hospitalization: National Institutes of Health Stroke Scale to quantify
stroke severity and the HMS to verify the degree of mobility. The
primary outcome was the proportion of unfavorable functional outcomes,
defined as a modified Barthel Index of <95.
Results. We
defined 3 tasks for HMS: sitting, standing, and gait. In the derivation
cohort, the HMS presented an accuracy of 84.5% measured using the area
under the receiver operating characteristic curve (95% CI = 78.3-90.7; P < .001), whereas in the validation cohort the accuracy was 87.8% (95% CI = 81.9%-93.7%; P
< .001). The HMS presented a large standardized effect size (1.41)
and excellent interexaminer agreement (intraclass correlation
coefficient = 0.962; 95% CI = 0.917-0.983; P < .001).
Conclusion.
The HMS was able to predict accurately the functional outcome of
poststroke patients, presented excellent interexaminer agreement, and
was sensitive in detecting changes.
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