Development and Validation of the Short-LIMOS for the Acute Stroke Unit-A Short Version of the Lucerne ICF-Based Multidisciplinary Observation Scale.
Beatrice Ottiger, Tim Vanbellingen, Dario Cazzoli and 2 others
PMID 36189034WHAT IT FOUND
A 10-item stroke-unit observation scale rated motor, cognitive and communication daily tasks consistently, closely matched the original 45-item LIMOS, and tracked the Barthel Index moderately.
Key findings
01The Short-LIMOS was built from 10 LIMOS items selected to explain discharge ADL performance, with a final regression R2 of 0.738.
02In 416 validation patients, total scores had Cronbach's alpha 0.959 and test-retest ICC 0.922 over 1 to 4 days, with no floor or ceiling effects.
03Scores showed a moderate relationship with the Barthel Index (rs=0.67), high agreement with the original LIMOS (rs=0.99 or 0.98), and a minimum detectable change of 7.22 points on the 40-point range.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Intrarater and interrater reliability were not assessed. Test-retest reliability was estimated only in patients transferred to neurorehabilitation within 1 to 4 days, and early neurological improvement may have changed performance during that interval. 64 of 480 Short-LIMOS files were missing or incomplete; those patients had lower NIHSS scores and shorter acute stroke unit stays, so the analysed sample may not represent all acute stroke patients and the ceiling effect may be underestimated. Construct validity against the Barthel Index was tested only in 278 patients because the electronic record system changed in September 2019. The paper did not study whether Short-LIMOS scores predict discharge destination. The data came from one Swiss neurocenter, so other acute stroke units may differ.
Declared interests
The study was supported by SNF Grant No. 32003B_196915 from the Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung. The authors declared no commercial or financial relationships that could be construed as a potential conflict of interest.
The easy way to misread this
Do not conclude that the Short-LIMOS improves stroke outcomes or discharge decisions. It is an observation scale, not a treatment, and the paper did not test its predictive ability for discharge destination.