Handbook of Neurologic Rating Scales.

Handbook of Neurologic Rating Scales

Herndon RM. New York, NY 10016, Demos Vermande, 1997, hardcover, 276 pp, illus, $125.

Today's health care system places increasing emphasis on outcomes assessment and standardization of data collection. The Handbook of Neurological Rating Scales was written to serve as a reference text containing the rating scales commonly used within neurology and neurological clinical trials. The book provides information on each of the scales in a standardized format that typically includes background information and purpose; descriptions of the scale, validation efforts, administration and scoring, special considerations, and advantages and disadvantages; and a summary. Unless the scale is excessively long or it is copyrighted, the scales are reproduced within the book. The text includes a 3.5-in diskette that contains the scales shown in the book.

The volume is divided into 10 chapters. Chapter 1 provides an introduction to clinical neurological scales, including discussions of the World Health Organization model for classification of the consequences of diseases (the International Classification of Impairments, Disabilities, and Handicaps) and the characteristics of useful scales. The pediatric developmental scales in chapter 2 cover items such as the American Association on Mental Deficiency Adaptive Behavior Scale, the Bellevue Index of Depression, the Connors Teacher Rating Scale, the Denver Developmental Screening Test, and the Dubowitz Scale. Chapter 3 presents 4 clinimetric scales for amyotrophic lateral sclerosis (ALS): the Norris ALS Scale, the Appel ALS Scale, the ACTS (Amyotrophic lateral sclerosis Ciliary neurotrophic factor Treatment Study) ALS Evaluation, and the ALS Functional Rating Scale.

The scales for the assessment of movement disorders covered in chapter 4 are the Unified Parkinson Disease Rating Scale, a dyskinesia rating scale, a dystonia movement scale, spasmodic torticollis rating scales, the Tourette Syndrome Global Scale, and the Abnormal Involuntary Movement Scale. Chapter 5 on multiple sclerosis (MS) and demyelinating diseases discusses 3 different criteria sets used to establish the diagnosis of MS and 10 rating scales that measure different aspects of the consequences of MS-related pathology. Chapter 6, on the examination of individuals with dementia, covers 17 instruments or inventories dealing with 4 aspects of functioning that are affected by dementia--cognitive status, functional abilities, overall function, and behavior.

Eighteen clinical stroke scales are presented in chapter 7. These scales fall into several categories, including stroke-specific quantifications of neurological status, such as the National Institutes of Health Stroke Scale and the Scandinavian Stroke Scale; global functional outcome scales, such as the Glasgow Outcome Scale; and activities-of-daily-living scales, such as the Barthel Index and the Functional Independence Measure (FIM). Chapter 8, on the assessment of outcomes following traumatic brain injury in adults, addresses the measurement of the severity of involvement and the assessment of outcomes in the acute phase. It also covers the measurement of outcomes in the postacute phase through assessments completed by the providers of therapy and through assessments completed by the consumers of therapy--both patients and families. Chapter 9 presents 6 health-related quality-of-life scales for adults with epilepsy and discusses the limited literature on health-related quality-of-life scales for children and adolescents with epilepsy.

The last chapter addresses the topic of rehabilitation outcome measures. The reader is referred to previous chapters for scales related to impairments. The disability scales presented include the Barthel Index and the Assessment of Motor and Process Skills (AMPS), and the handicap level measures include the Craig Handicap Assessment and Reporting Technique (CHART) and the Community Integration Questionnaire. The final grouping of scales in this chapter are health status measures such as the Sickness Impact Profile (SIP) and the 36-Item Short Form (SF-36) Health Survey.

Physical therapists should note that the purpose of this text is specifically limited to scales that are applicable to clinical trials and, therefore, the book does not include some scales that are used to measure aspects related to rehabilitation. The inclusion of a number of the scales in tables provides the reader with an easy reference for scoring these scales. Each chapter is well referenced, and the location of the references at the end of each chapter provides easy access to the disease-specific citations.

Each of the chapters consistently follows the organization described in the preface. Because each chapter was prepared by a different set of authors, however, the depth of the information varies. One chapter contains a series of figures summarizing the author's research related to one scale. The majority of chapters, however, briefly cite the findings from other studies.

The inclusion of a diskette with the book is an interesting concept; however, neither the text itself nor the diskette label tells users the specific word processing program they should use to open the files. As a result, individuals with limited computer knowledge may have problems accessing the files. The content of the diskette appears to be the same as the scales presented in table format within the text.

Physical therapists seeking information on the neurological scales appropriate to clinical trial studies should find this text to be a useful reference. The compilation of information and, particularly, the presentation of the scoring format for many of the scales will help the reader gain a perspective on these scales.

Rebecca E Porter, PhD, PT

Indiana University

Indianapolis, Ind

Dr Porter is Associate Professor and Coordinator of Graduate Studies in the physical therapy program. Her teaching and clinical practice are in the areas of neuroscience and neurological physical therapy.