Use of Physical Therapy Outcome Measures to Predict Discharge Destination in People With Stroke From Acute Care Hospital

The MSAS is a six-item scale which consists of components that are routinely assessed in patients by physical therapists. The components are bridging, sit from supine and then return to supine, sitting balance to be held for 3 minutes, sit to stand from a chair without using arms, standing balance for 1 minute, and gait testing for 10 m with or without an assistive device. The scores for each domain range from 6 to 36. The cut off score is 26 with scores above 26 indicating possible discharge to home and below 26 indicating need for institutionalization.

The PASS consists of 12-items assessing balance ability to maintain postures or while changing postures. The score range for the PASS is 0 to 36 with lower scores indicating greater balance impairments. The 12 items consist of sitting without support, standing with support, standing without support, standing on nonparetic leg, standing on paretic leg, supine to paretic side lateral, supine to nonparetic side lateral, supine to sitting up on edge of the mat, sitting on the edge of the mat to supine, sitting to standing up, standing up to sitting down, and standing - picking up a pencil from the floor.

The AM-PAC was developed to assess activity level post-acute care. It consists of three domains - basic mobility, daily activity, and applied cognition and each of the three domains consists of six items. The raw scores for each domain range from 6 to 24. A higher raw score indicates less functional limitations. The cutoff score for medically complex patients is 42.9 for the basic mobility domain and 39.4 for the daily activity domain.

The OPS consists of four domains namely deficits in upper extremity strength, upper extremity proprioception, balance, and cognition. The total score consists of adding all four domains together along with 1.6. The total score can range from 1.6 to 6.8. The cutoff scores range from < 3.2 to > 5.2, where < 3.2 indicates a high likelihood of discharge home; a score between 3.2 and 5.2 respond better to inpatient rehabilitation; and a score of > 5.2 indicates increased risk of institutionalization as patients are typically dependent.

The MRS is a global outcomes rating scale which ranges from 0 (no impairment) to 5 (severe disability- patient is bedridden, incontinent, and requires constant nursing care and attention) and 6 (death). A higher score indicates greater impairment.

The FCI was developed to assess comorbidity and used physical function as the outcome. It consists of an 18-item list of diagnoses. The scores range from 0 to 18 which is the cumulative sum of the comorbidities present.