Table of Contents
To view the fulltext, log-in or choose pay-per-view options:
Get Access

Validation of the National Institutes of Health Stroke Scale, Modified Rankin Scale and Barthel Index in Brazil: The Role of Cultural Adaptation and Structured Interviewing

Cincura C.a · Pontes-Neto O.M.c · Neville I.S.a · Mendes H.F.c · Menezes D.F.a · Mariano D.C.c · Pereira I.F.a · Teixeira L.A.c · Jesus P.A.P.a · de Queiroz D.C.L.c · Pereira D.F.a · Pinto E.a · Leite J.P.c · Lopes A.A.b · Oliveira-Filho J.a
aStroke Clinic and bEpidemiology Unit of the Federal University of Bahia, Salvador, and cNeurology Service of Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil Cerebrovasc Dis 2009;27:119–122 (DOI:10.1159/000177918)


Background: We aimed to validate three widely used scales in stroke research in a multiethnic Brazilian population. Methods: The National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS) and Barthel Index (BI) were translated, culturally adapted and applied by two independent investigators. The mRS was applied with or without a previously validated structured interview. Interobserver agreement (kappa statistics) and intraclass correlation coefficients were calculated. Results: 84 patients underwent mRS (56 with and 28 without a structured interview), 57 BI and 62 NIHSS scoring. Intraclass correlation coefficient was 0.902 for NIHSS and 0.967 for BI. For BI, interobserver agreement was good (kappa = 0.70). For mRS, the structured interview improved interobserver agreement (kappa = 0.34 without a structured interview; 0.75 with a structured interview). Conclusion: The NIHSS, BI and mRS show good validity when translated and culturally adapted. Using a structured interview for the mRS improves interobserver concordance rates.


Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

Pay-per-View Options
Direct payment This item at the regular price: USD 33.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 23.00