Knowledge and use of Stroke Assessment Scales by Physiotherapists in selected Nigerian Health Institutions

Udoka Chris Okafor, Bridget N Birabi, A Okunuga


Background & Objective: Stroke assessment scales are top among core British National Clinical Guidelines for Stroke that has been strongly advocated by the Intercollegiate Stroke Working Party (ISWP). These clinical assessment measures have been studied for validity and reliability and have been in use globally by clinicians for over three decades. Knowledge and use of stroke scales by Physiotherapists in Nigeria will be a strong tool in improving the quality of care and life of stroke survivors. This study therefore sought to evaluate the level of knowledge, availability and utilization of stroke scales among Physiotherapists in Nigeria.

Methods: Two hundred (200), two-part, 18-item, self administered questionnaires were distributed to a convenient sample of Nigerian Physiotherapists practicing in urban and suburban hospitals spread over four out of six geopolitical zones of Nigeria. One hundred and eighty (180) respondents (90%) returned fully completed questionnaires.

Results: Of the 180 respondents, 66.7% had knowledge of stroke scales though only 28% claimed they were taught in their training institutions. Three types of scales were mainly available among 30.6% of respondents in their institutions of practice. However, 70% of these respondents to whom these scales were available do not utilize them mostly due to high patient load and time constraint in clinical setting. All participants (100%) desired knowledge and availability of the scales while 90% strongly agreed that stroke scales make the patient, essential part of goal setting and accelerates his re- integration into the society after stroke.

Conclusion: Knowledge of stroke assessment scales is low among Physiotherapists in Nigeria. Even among those who have knowledge of the scales, there is low availability and utilization in the treatment of stroke. Therefore, improvement in knowledge, availability and utilization of stroke assessment scales by Physiotherapists in Nigeria is imperative.


Stroke Assessment Scales, Physiotherapy

Full Text:



? Akinpelu OA, Eluchie NC (2006). Familiarity with, knowledge, and utilization of standardized outcome measures among physiotherapists in Nigeria. Physiotherapy Theory and Practice. 22(2): 61-72

? American Heart Association (1998). The A.H.A Stroke Outcome Classification: Executive Summary Circulation. 97:2474-2478.

? Banks JL and Marotta CA (2007). Outcomes validity and reliability of the modified Ranking scale: Implications for stroke clinical trials; a literature review and synthesis. Stroke. 38 (3): 1091-1096.

? Fumio Gotoh, Yasuo Terayama, Takahiro Amano (2001). Development of a novel, weighted quantifiable stroke scale; Stroke. 32: 1800-1807.

? Hantson L, De Weerdt W et al., (1994).The European stroke scale. Stroke. 25: 2215- 2219.

? Hsueh I, Lin J, Jeng J, and Hsieh C (2002).Comparison of the Psychometric characteristics of the functional independence measure, 5 item Barthel index and 10 item Barthel index with patients with stroke. J. Neurol Neurosurg Psychiatry 73(2):188-190

? Intercollegiate Working Party for Stroke (2002).National Clinical Guidelines for Stroke, 2nd edn. London: Royal College of Physicians 2002. available at http://

? Karen CJ, Alfred FC, Douglas PW, and Clarke H (2003). Predicting outcome in ischaemic stroke; External validation of predictive risk models. Stroke 34(1):200-202.

? Maas MB, Furie KL, Lev MH, Hakan A, Singhal AB, David M et al., (2009). NIHSS score is poorly predictive of proximal occlusions in acute cerebral ischaemia. Stroke. 40:2988-2993.

? Richardson Jenny; Murray Diana; House Ken; Lowenkopf Ted (2006) Successful implementation of the National Institutes of Health Stroke Scale on a Stroke/Neurovascular Unit. J Neurosci Nurs. 38(4):309-314.

? Rothwell P, Giles M, Flossmann E, Lovelock C, Redgrave J, Warlow C, & Mehta Z (2005). A simple tool to identify individuals at high early risk of stroke after a transient ischaemic attack: the ABCD score. The Lancet 366:29-36.

? U.S Agency for Health Care Policy and Research (1995).

Preferred Standard Instrument for patient assessment in stroke. Publication no. 95-0663

? William L.S et al., (1999). Development of a stroke quality of life scale. Stroke (7)1362-9 consequences of falls due to stroke: a systematic inquiry. International Rehabilitation Medicine. 2: 177-80.


  • There are currently no refbacks.