Title
A novel multiple-cue observational clinical scale for functional evaluation of gait after stroke - The stroke mobility score (SMS)
Date Issued
15 September 2020
Access level
open access
Resource Type
journal article
Author(s)
Raab D.
Diószeghy-Léránt B.
Wünnemann M.
Zumfelde C.
Cramer E.
Rühlemann A.
Wagener J.
Gegenbauer S.
Jäger M.
Zietz D.
Hefter H.
Kecskeméthy A.
Siebler M.
Universidad de Duisburg-Essen
Publisher(s)
International Scientific Information, Inc.
Abstract
Background: For future development of machine learning tools for gait impairment assessment after stroke, simple observational whole-body clinical scales are required. Current observational scales regard either only leg movement or discrete overall parameters, neglecting dysfunctions in the trunk and arms. The purpose of this study was to introduce a new multiple-cue observational scale, called the stroke mobility score (SMS). Material/Methods: In a group of 131 patients, we developed a 1-page manual involving 6 subscores by Delphi method using the video-based SMS: trunk posture, leg movement of the most affected side, arm movement of the most affected side, walking speed, gait fluency and stability/risk of falling. Six medical raters then validated the SMS on a sample of 60 additional stroke patients. Conventional scales (NIHSS, Timed-Up-And-Go-Test, 10-Meter-Walk-Test, Berg Balance Scale, FIM-Item L, Barthel Index) were also applied. Results: (1) High consistency and excellent inter-rater reliability of the SMS were verified (Cronbach's alpha >0.9). (2) The SMS subscores are non-redundant and reveal much more nuanced whole-body dysfunction details than conventional scores, although evident correlations as e.g. between 10-Meter-Walk-Test and subscore “gait speed” are verified. (3) The analysis of cross-correlations between SMS subscores unveils new functional interrelationships for stroke profiling. Conclusions: The SMS proves to be an easy-to-use, tele-applicable, robust, consistent, reliable, and nuanced functional scale of gait impairments after stroke. Due to its sensitivity to whole-body motion criteria, it is ideally suited for machine learning algorithms and for development of new therapy strategies based on instrumented gait analysis.
Volume
26
Language
English
OCDE Knowledge area
Medicina clínica
Scopus EID
2-s2.0-85091053898
PubMed ID
Source
Medical Science Monitor
ISSN of the container
12341010
Sponsor(s)
Dominik Raab, e-mail: dominik.raab@uni-due.de German federal state of North Rhine Westphalia and the European Union (European Regional Development Fund), grant numbers 005-1111-{0054, 0055, 0056, 0057} and 08009-{48, 49, 62, 63, 90, 91} German federal state of North Rhine Westphalia and the European Union (European Regional Development Fund), grant numbers 005-1111-0054, 005-1111-0055, 005-1111-0056, 005-1111-0057 and 08009-48, 08009-49, 08009-62, 08009-63, 08009-90, 08009-91
Sources of information: Directorio de Producción Científica Scopus