title: Feasibility of the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) in adults.
abstract: This article describes the design and initial implementation of the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) as an adaptation of the National Institutes of Health Stroke Scale (NIHSS), specifically for clinical and research use in patients with TBI, including (1) the addition of items specific to TBI, (2) adjustment to the scoring algorithm to allow quantification of deficits in patients who are comatose/vegetative or agitated, and (3) the reassignment of items (i.e., limb ataxia) that are problematic in TBI as supplemental items. The feasibility of using the NOS-TBI is discussed and limitations of the scale are highlighted. This scale offers (1) a cost-effective, brief, practicable, standardized, and quantifiable method of communicating and analyzing neurological deficits in a way that traditional neurological assessment alone cannot currently provide, and (2) a measure that non-physicians can administer. The NOS-TBI may serve a role in clinical practice in patients with TBI similar to the way the NIHSS has functioned for patients following stroke, by serving as a tool for initial stratification of injury severity, and as an outcome measure in clinical trials.
authors.affiliation: Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the Department of Neurology, the University of Texas-Houston Medical School, Houston, Texas 77030, USA. ewilde@bcm.edu
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.forename: Stephen R
authors.initials: SR
authors.lastname: McCauley
authors.forename: Tara M
authors.initials: TM
authors.lastname: Kelly
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
authors.forename: Claudia
authors.initials: C
authors.lastname: Pedroza
authors.forename: Guy L
authors.initials: GL
authors.lastname: Clifton
authors.forename: Claudia S
authors.initials: CS
authors.lastname: Robertson
authors.forename: Alex B
authors.initials: AB
authors.lastname: Valadka
authors.forename: Paolo
authors.initials: P
authors.lastname: Moretti
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000534:rehabilitation*; D006801:Humans; D009316:National Institutes of Health (U.S.); D009460:Neurologic Examination / Q000379:methods*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014481:United States