Outcome measures in stroke rehabilitation

Owing to the complex nature of neurological disease and trauma, comprehensive and standardized assessments are needed to evaluate individuals effectively. No one standardized assessment is applicable for every situation as each test serves a different purpose. Assessments are either generic or disease specific. However, in neurological rehabilitation, most assessments are disease specific as the generic measures may not be precise for outcomes. This chapter outlines some of the challenges and considerations that the test administrator needs to consider when selecting the most appropriate and corresponding assessment. Four key factors are suggested for determining which assessment to use:. 1.Conceptual Framework describes the many factors that are involved in determining an individual's level of disability as defined by the WHO's International Classification of Function, Disability, and Health (ICF).2.Psychometric Properties evaluates the characteristics of assessments and explains the dilemma of the floor to ceiling effects where assessments are less sensitive to important clinical changes.3.Mode of Administration and Source of Information explains that the administration of test varies and can interact with the results of the assessment. The literature suggests that healthcare professionals have a tendency to rate patients as higher functioning than the patients in self-report. Accepting bias as a factor in scoring subjective portions of different assessments can provide useful motivation for investigators to emphasize consistency of raters.4.Respondent Burden and Feasibility will naturally be a consideration for assessments. Individual respondents can become overwhelmed and multiple providers should not be asking the same questions and overlapping assessments. In addition, assessments must not burden clinical care.