Disclosures: George Ghafari: No financial relationships or conflicts of interest

Background and/or Objectives

The Stroke Upper Limb Capacity Scale (SULCS) evaluates Upper-Extremity (UE) capacity using ten functional tasks. Its ability to detect change in UE capacity within the few days post-stroke is unknown. The objective of this study is to determine the statistical responsiveness of the SULCS in early stroke, termed a distribution-based approach.

Participants

N&#3f261/488 (53%) admissions with complete data, age=69±15 years, time post stroke=10±10 days, length of stay=15±8.0 days, female=46%, National Institute of Health Stroke Scale=7.9±6.9, total admission Functional Independence Measure (FIM)=60±20, admission Motricity Index-Upper Extremity (MI-UE)=65±35.

Interventions

N/A

Main Outcome Measures

SULCS, FIM and MI-UE were administered by occupational therapists at IRU admission and discharge. Standardized Response Mean (SRM) of the SULCS, FIM and MI-UE were calculated. Minimal Detectable Change at the 90% and 95% confidence levels (MDC90 and MDC95, respectively) were computed for SULCS, as well as Cohen’s d effect size.

Results

SULCS admission and discharge scores were, respectively, 5.6±3.6 and 6.9±3.3. Mean change scores for SULCS, FIM and MI-UE were, 1.3±1.7, 21±12 and 11±15, respectively. The SRM for SULCS, MI-UE and FIM were 0.78, 0.75, and 1.78, respectively. SULCS’ MDC90 and MDC95 were, respectively, 0.52 and 0.62. Cohen’s d was 0.37.

Conclusions

The similar SRM for SULCS and MI-UE reflected constructs of UE capacity and impairment. A higher SRM for FIM could be due to this scale’s additional breadth in assessing mobility, cognition and communication. By definition, the MDC90 and MDC95 demonstrated a level of change which likely exceeds measurement error. Cohen’s d reflected the SULCS ability to detect a moderately low effect size during inpatient rehabilitation. We provide an assessment of SULCS responsiveness from IRU admission to discharge in patients early post-acute stroke. Further research should use a more clinically rooted or anchor-based approach to describe SULCS responsiveness.

Level of Evidence: Level III

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/responsiveness-of-the-stroke-upper-limb-capacity-scale-in-an-acute-inpatient-setting/