Look closer: the multidimensional patterns of post-stroke burden behind the modified Rankin Scale

Rethnam, Venesha, Bernhardt, Julie, Johns, Hannah, Hayward, Kathryn S, Collier, Janice M, Ellery, Fiona, Gao, Lan, Moodie, Marj, Dewey, Helen, Donnan, Geoffrey A and Churilov, Leonid 2020, Look closer: the multidimensional patterns of post-stroke burden behind the modified Rankin Scale, International journal of stroke, pp. 1-9, doi: 10.1177/1747493020951941.

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Title Look closer: the multidimensional patterns of post-stroke burden behind the modified Rankin Scale
Author(s) Rethnam, Venesha
Bernhardt, Julie
Johns, Hannah
Hayward, Kathryn S
Collier, Janice M
Ellery, Fiona
Gao, LanORCID iD for Gao, Lan orcid.org/0000-0001-9734-1140
Moodie, MarjORCID iD for Moodie, Marj orcid.org/0000-0001-6890-5250
Dewey, Helen
Donnan, Geoffrey A
Churilov, Leonid
Journal name International journal of stroke
Start page 1
End page 9
Total pages 9
Publisher SAGE Publications
Place of publication London, Eng.
Publication date 2020-08-27
ISSN 1747-4930
Keyword(s) Science & Technology
Life Sciences & Biomedicine
Clinical Neurology
Peripheral Vascular Disease
Neurosciences & Neurology
Cardiovascular System & Cardiology
Modified Rankin Scale
primary outcome measure
assessment of quality of life
A Very Early Rehabilitation Trial
Barthel Index
Summary Background The utility-weighted modified Rankin Scale, representing patient perspectives of quality of life, is a newly proposed measure to improve the interpretability of the modified Rankin Scale. Despite obvious advantages, such weighting imperfectly reflects the multidimensional patterns of post-stroke burden. Aims To investigate multidimensional patterns of post-stroke burden formed by individual domains of Assessment of Quality of Life and Barthel Index for each modified Rankin Scale category. Methods In the A Very Early Rehabilitation Trial (n = 2104), modified Rankin Scale scores and modified Rankin Scale-stratified Barthel Index scores of Self-care and Mobility, and Assessment of Quality of Life scores of Independent Living, Senses, Mental Health and Relationships were collected at three months. The multivariate relationship between individual Assessment of Quality of Life and Barthel Index domains, and modified Rankin Scale was investigated using random effects linear regression models with respective interaction terms. Results Of 2104 patients, simultaneously collected Assessment of Quality of Life, Barthel Index and modified Rankin Scale scores at three months were available in 1870 patients. While individual Assessment of Quality of Life and Barthel Index domain scores decreased significantly as modified Rankin Scale increased (p < 0.0001), the patterns of decrease differed by domains (p < 0.0001). Patients with modified Rankin Scale 0–1 had the largest post-stroke burden in the Mental Health and Relationship domains, while patients with modified Rankin Scale >3 showed the greatest burden in Independent Living, Mobility and Self-care domains. Conclusions Across the modified Rankin Scale, individual domains are varyingly impacted demonstrating unique patterns of post-stroke burden, which facilitates appropriate assessment, articulation and interpretation of the modified Rankin Scale and utility-weighted modified Rankin Scale.
Language eng
DOI 10.1177/1747493020951941
Indigenous content off
Field of Research 1103 Clinical Sciences
1109 Neurosciences
HERDC Research category C1 Refereed article in a scholarly journal
Persistent URL http://hdl.handle.net/10536/DRO/DU:30143077

Document type: Journal Article
Collections: Faculty of Health
School of Health and Social Development
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