{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T13:08:13Z","timestamp":1767704893104},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[1997,6]]},"abstract":"<jats:p>\n            <jats:italic>Background and Purpose<\/jats:italic>\n            The scale of stroke impairment characteristics by Brott and associates, the National Institutes of Health (NIH) Stroke Scale, has been used widely in various studies of stroke outcome; however, the measurement properties of the items applied to patients during medical rehabilitation have not been evaluated thoroughly. This study evaluated the extent to which scale items cohere to define a unidimensional construct and have a useful range for application to patients during medical rehabilitation.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods<\/jats:italic>\n            Rating scale (or Rasch) analysis of the 15 NIH Stroke Scale items was conducted using the BIGSTEPS computer program to evaluate (1) the range of impairment assessed by the items, (2) the items\u2019 coherence with an underlying construct of impairment, and (3) range of impairment measured in rehabilitation patients. We sought to maximize the range of impairment measured by conducting analyses recursively; at each subsequent step, the worst fitting item was deleted or rescored. The sample comprised 1291 admission and discharge records from 693 rehabilitation inpatients with stroke.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Results<\/jats:italic>\n            Thirteen items arrayed the sample across a sufficient range of impairment. The limb ataxia item fit poorly and was deleted; lower ratings for this item were associated with higher scores on the total scale. Pupillary response was also deleted because ratings reflected poor congruence with the total score. Best language was rescored because intermediate ratings were inconsistently related to the total score. Patients with hemorrhagic strokes had poorer fitting measures than did patients with ischemic strokes.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            The items in a revised NIH Stroke Scale worked well together to define the severity of impairment resulting from stroke that is observed during medical rehabilitation. Directions regarding limb ataxia should be modified to indicate untestability due to hemiplegia.\n          <\/jats:p>","DOI":"10.1161\/01.str.28.6.1174","type":"journal-article","created":{"date-parts":[[2011,6,17]],"date-time":"2011-06-17T20:08:03Z","timestamp":1308341283000},"page":"1174-1180","update-policy":"http:\/\/dx.doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":28,"title":["Measurement Properties of the NIH Stroke Scale During Acute Rehabilitation"],"prefix":"10.1161","volume":"28","author":[{"given":"Allen W.","family":"Heinemann","sequence":"first","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard L.","family":"Harvey","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"McGuire","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dinora","family":"Ingberman","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Lovell","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Semik","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elliot J.","family":"Roth","sequence":"additional","affiliation":[{"name":"From the Rehabilitation Institute of Chicago (A.W.H., R.L.H., J.R.M., D.I., L.L., P.S., E.J.R.) and the Department of Physical Medicine and Rehabilitation, Northwestern University Medical School (A.W.H., R.L.H., J.R.M., D.I., E.J.R.), Chicago, Ill."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.20.7.2749846"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.1989.00520420080026"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.26.8.1358"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/str.25.11.7974549"},{"key":"e_1_3_2_5_2","unstructured":"World Health Organization. Classification of impairments disabilities and handicaps. Geneva Switzerland: World Health Organization; 1980."},{"key":"e_1_3_2_6_2","unstructured":"US Department of Health and Human Services. Post-Stroke Rehabilitation. AHCPR publication 95-0662 May 1995."},{"key":"e_1_3_2_7_2","unstructured":"Rasch G. Probabilistic Models for Some Intelligence and Attainment Tests. Copenhagen Denmark: Danmarks Paedogogiske Institut; 1960 (Chicago Ill: University of Chicago Press; 1980)."},{"key":"e_1_3_2_8_2","unstructured":"Wright BD Masters G. Rating scale analysis: Rasch measurement. Chicago Ill: MESA Press; 1982."},{"key":"e_1_3_2_9_2","unstructured":"Linacre JM. BIGSTEPS for PC Compatibles. Chicago Ill: Mesa Press; 1995."},{"key":"e_1_3_2_10_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/0003-9993(94)90384-0","volume":"75","year":"1994","unstructured":"Linacre JW, Heinemann AW, Wright BD, Granger C, Hamilton BB. The structure and stability of the Functional Independence Measure. Arch Physical Med Rehabil. 1994;75:127-132.","journal-title":"Arch Physical Med Rehabil"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(95)80020-4"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(95)80523-0"},{"key":"e_1_3_2_13_2","first-page":"519","volume":"73","year":"1992","unstructured":"Whiteneck GG, Charlifue SW, Gerhart KA, Richardson GN. Quantifying handicap: a new measure of long-term rehabilitation outcomes. Arch Phys Med Rehabil. 1992;73:519-526.","journal-title":"Arch Phys Med Rehabil"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.STR.28.6.1174","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T22:12:39Z","timestamp":1715551959000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.STR.28.6.1174"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1997,6]]},"references-count":13,"journal-issue":{"issue":"6","published-print":{"date-parts":[[1997,6]]}},"alternative-id":["10.1161\/01.STR.28.6.1174"],"URL":"https:\/\/doi.org\/10.1161\/01.str.28.6.1174","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[1997,6]]},"assertion":[{"value":"1996-08-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-03-14","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-06-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}