The American Heart Association Stroke Outcome Classification: executive summary.

Stroke remains one of the major public health problems in the United States today, with approximately 500 000 new or recurrent cases occurring each year.1 About 4 000 000 persons alive today have survived a stroke and have some neurological deficits. Although the magnitude of healthcare resources used to treat and rehabilitate stroke survivors is considerable, to date a standardized, comprehensive classification system to document the resultant impairments and disability has not been developed. Successful management of any disabling disease, including stroke, should benefit from the use of a classification system to judge the impact of treatment, particularly emerging therapies. Participants in the Methodologic Issues in Stroke Outcome Symposium2 determined that the complex nature of stroke recovery demands clarification of its natural history and classification of the variable patterns of functional recovery. For stroke survivors to receive the best care, a comprehensive stroke outcome classification system is needed to direct appropriate therapeutic interventions.3 Building on the work and recommendations of the Stroke Outcome Symposium, the American Heart Association Classification of Stroke Outcome Task Force has worked to develop a valid and reliable global classification system that accurately summarizes the neurological impairments, disabilities, and handicaps that occur after stroke. The development of a stroke outcome classification system is predicated on the belief that neurological deficits often lead to permanent impairments, disabilities, and compromised quality of life.4 5 6 Although a person’s ability to complete daily functional tasks is thought to be largely dependent on and often limited by the type and degree of impairment, additional factors are often relevant in the ultimate determination of functional outcome.7 8 9 Thus, a classification of stroke outcome should include the broad range of disabilities and impairments as well as the relationship of disability and impairment to independent function. It …

[1]  Mahoney Fi,et al.  FUNCTIONAL EVALUATION: THE BARTHEL INDEX. , 1965 .

[2]  M. Sussman,et al.  SOCIOLOGY AND REHABILITATION , 1967 .

[3]  M. Lawton.  Assessing the competence of older people , 1969 .

[4]  E A Bullock,et al.  Post-stroke rehabilitation. , 1975, Royal Society of Health journal.

[5]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[6]  L. Radloff.  The CES-D Scale , 1977 .

[7]  V. Leirer,et al.  Development and validation of a geriatric depression screening scale: a preliminary report. , 1982, Journal of psychiatric research.

[8]  R. Robinson,et al.  A two‐year longitudinal study of post‐stroke mood disorders: findings during the initial evaluation. , 1983, Stroke.

[9]  J. Langston,et al.  The Neurobehavioral Cognitive Status Examination: a brief but quantitative approach to cognitive assessment. , 1987, Annals of internal medicine.

[10]  J. Marler,et al.  Measurements of acute cerebral infarction: a clinical examination scale. , 1989, Stroke.

[11]  V Hachinski,et al.  The Canadian Neurological Scale , 1989, Neurology.

[12]  G. E. Gresham.  Past achievements and new directions in stroke outcome research. , 1990, Stroke.

[13]  J. Williams,et al.  Examining outcome measures in a clinical study of stroke. , 1990, Stroke.

[14]  The call for action. , 1990 .

[15]  Andrew M. Pope,et al.  Disability in America: Toward a National Agenda for Prevention. Summary and Recommendations. , 1991 .

[16]  A. Boland.  Disability in America: Toward a National Agenda for Prevention , 1992 .

[17]  M. Limburg,et al.  A Comparison of Five Stroke Scales With Measures of Disability, Handicap, and Quality of Life , 1993, Stroke.

[18]  M. Limburg,et al.  The Frenchay Activities Index: Assessment of Functional Status in Stroke Patients , 1993, Stroke.

[19]  B. Ford.  International Classification of Impairments, Disabilities and Handicaps , 1984, Releve epidemiologique hebdomadaire.

[20]  R L Hewer,et al.  Measuring Quality of Life in Stroke , 1993, Stroke.

[21]  M. Dolgin,et al.  Nomenclature and Criteria for Diagnosis of Diseases of the Heart and Great Vessels , 1994 .

[22]  Cynthia K. Thompson,et al.  Functional Assessment of Communication Skills for Adult , 1995 .

[23]  R. Zorowitz,et al.  ADMISSION MOTOR IMPAIRMENT AS A PREDICTOR OF PHYSICAL DISABILITY AFTER STROKE REHABILITATION , 1995, American journal of physical medicine & rehabilitation.