[Neurological Reha-Score. An instrument to measure outcome and expenditure of neurologic rehabilitation].
BACKGROUND
A new measurement instrument was developed to combine common scores with the parameter of effort for rehabilitation, the latter being a control instrument for medical professionals and rehabilitational health organisations.


METHODS
The Neurological Rehabilitation Score (NRS) contains 61 items (including the ten from the Barthel Index) resulting in scores of 0 (worst patient condition) to 600 (best). The items are grouped into seven categories: activities of daily life (13), mobility (8), communication and social skills (7), arm and hand function (7), orientation and cognition skills (10), strength and pain (8), and coping and miscellaneous (8). We investigated 8,139 patients and determined reliability (kappa statistic) and responsivity (standardised response means). In 100 consecutive patients, we also measured the Functional Independence Measure (FIM) and Scandinavian Stroke Scale (SSS) to address validity.


RESULTS
With an average kappa value of 0.86 (range 0.62-0.98), the NRS showed excellent inter-rater reliability. There was a good correlation between NRS, FIM, and SSS. Response was good at 0.84. The ceiling effect was also less than 1%, compared to 17% in the Barthel Index.


CONCLUSIONS
The NRS was shown to be effective for evaluation of outcome and expenditure in neurological rehabilitation.
Thilmann
A
A
Neurologische Abteilung, Fachklinik Rhein/Ruhr, Auf der Rötsch 2, 45219 Essen, Germany. t@drthilmann.de
Nachtmann
A
A
Scharff
A
A
D000203:Activities of Daily Living / Q000145:classification; D000328:Adult; D000368:Aged; D003142:Communication; D004185:Disability Evaluation; D005858:Germany; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D051346:Mobility Limitation; D009422:Nervous System Diseases / Q000191:economics / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D026741:Physical Therapy Modalities / Q000191:economics*; D012047:Rehabilitation Centers / Q000191:economics*; D012919:Social Behavior