Use of Stroke Scales in Clinical Practice: Current Concepts

With stroke being the leading global cause of disability in adults, the use of clinical rating scales in stroke patients is important not only for diagnostic and therapeutic purposes but also for prognostic and care implications. Scales that quantify neurological disability can be particularly useful for assessing and guiding decisions in acute management and rehabilitative treatment. We analyzed and discussed some of the main rating scales most used in stroke in clinical practice, which measure both acute neurological deficit and functional outcome in stroke. In acute stroke, it is that in most cases, the scales evaluate a neurological deficit attributable to an alteration of the anterior and not posterior circulation and most of them assess a moderate stroke rather than a mild or severe one. In a rehabilitation treatment, they are sometimes too simplified; thus, the patient can reach a near-normal score and can have significant cognitive deficits that can affect both the possibility of communication and the reliability of responses. A patient with autonomy in the activities of daily living may not be completely autonomous. In future, the use of composite rating scales could be useful for a detailed measurement of neurological deficits in acute stroke and better assess the efficacy of a treatment and functional outcome.