Determining cut-off points in functional assessment scales in stroke.
BACKGROUND
A wide variety of well-validated assessment scales of functioning and disability have been developed for stroke population. However, these instruments have limitations in their interpretation. Therefore, determining cut-off points for their categorization becomes necessary.


OBJECTIVE
To determine cut-off points for the BI, FIM and FAM scales to differentiate clinical disability categories and to establish the relationship between mRS and DOS scales.


METHODS
One hundred and six adults with ischemic or haemorrhagic stroke were mainly recruited from a rehabilitation facility (Hospitales Nisa, Valencia, Spain).


RESULTS
A high correlation was observed between the DOS and mRS scales (Kendall's tau-b = 0.475; p = 0.000) although a certain amount of disagreement between the two scales was detected. The cut-off points were 62.90 (95% CI, 57.26-69.29) and 21.30 (95% CI, 16.34-26.03) for the BI; 70.62 (95% CI, 66.65-75.22) and 38.29 (95% CI, 34.07-42.25) for the FIM; and 116.07 (95% CI, 110.30-122.68) and 66.02 (95% CI, 59.20-72.35) for the FAM.


CONCLUSIONS
DOS was observed to be more demanding than the mRS, in terms of patient independence. Additionally, the lower cut-off points separating the levels of severe and moderate disability in the BI, FIM and FAM were determined. These findings would facilitate practitioners clinical interpretation of disability levels in post-stroke patients.
Department of Physiotherapy, Universidad de Valencia, Valencia, Spain.
Mercè
M
Balasch i Bernat
Department of Applied Statistics and Operational Research, and Quality, Universidad Politécnica de Valencia, Valencia, Spain.
Sebastiá
S
Balasch i Parisi
Neurorehabilitation Service at Hospitales NISA, Valencia, Spain.
Enrique Noé
EN
Sebastián
Department of Physiotherapy, Universidad de Valencia, Valencia, Spain.
Lirios Dueñas
LD
Moscardó
Neurorehabilitation Service at Hospitales NISA, Valencia, Spain.
Joan
J
Ferri Campos
Department of Physiotherapy, Universidad de Valencia, Valencia, Spain.
Laura
L
López Bueno
D000203:Activities of Daily Living; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D020521:Stroke / Q000175:diagnosis; D000071939:Stroke Rehabilitation
Stroke; activities of daily living; clinical evaluation; disability; rehabilitation