Ann Rehabil Med.  2018 Jun;42(3):375-383. 10.5535/arm.2018.42.3.375.

Evaluation of Ataxia in Mild Ischemic Stroke Patients Using the Scale for the Assessment and Rating of Ataxia (SARA)

• Choi SW
• Han N
• Jung SH
• Kim HD
• Eom MJ
• Bae HW

• KMID: 2417829
• DOI: http://doi.org/10.5535/arm.2018.42.3.375

Abstract

OBJECTIVE
To demonstrate the utility of Scale for the Assessment and Rating of Ataxia (SARA) for evaluation of posterior circulation-related features in patients with mild stroke.
METHODS
Forty-five subjects, diagnosed with acute infarction in the cerebellum, basis pontis, thalamus, corona radiata, posterior limb of internal capsule, and their National Institutes of Health Stroke Scale (NIHSS) scores ≤5 were enrolled. SARA scores were graded by the cut-off value of severity in dependency of activities of daily living (ADL). SARA, Berg Balance Scale (BBS), Timed Up-and-Go (TUG), and Trunk Control Test (TCT) were correlated in regression analysis with the modified Rankin Scale (mRS) at discharge. Correlation between SARA and other tools was analyzed. Patients were divided based on mRS at admission (group A, mRS 0-2; group B, mRS 3-5). Scores between the two groups were compared.
RESULTS
Among the subjects, 48.9% (22/45) scored above 5.5 on SARA, and even 11.1% (5/45) scored higher than 14.25, which is the cut-off value of "˜severe dependency' in ADL. SARA showed significant value for prediction of mRS at discharge. SARA was correlated with BBS (r=-0.946, p < 0.001), TUG (r=-0.584, p < 0.001), and TCT (r=-0.799, p < 0.001). The SARA, BBS, TUG, and TCT scores between were lower in group B than in group A patients. SARA as well as BBS, TUG, and TCT reflect the functional severity of all patients.
CONCLUSION
SARA is a complementary tool for evaluation of the severity of ataxia in mild stroke patients with features of posterior circulation.

Keyword

Ataxia; Stroke; Scale for the Assessment and Rating of Ataxia

MeSH Terms

Activities of Daily Living
Ataxia*
Cerebellum
Extremities
Humans
Infarction
Internal Capsule
National Institutes of Health (U.S.)
Stroke*
Thalamus

Figure

• 

  Fig. 1. Scale for the Assessment and Rating of Ataxia (SARA) score graded by the cut-off value of severity in dependency of activities of daily living (ADL). SARA was assessed immediately after the patients’ release from absolute bed rest (within 5 days from admission). Values are presented as mean±standard deviation, ratio (%), and number of patients.

• 

  Fig. 2. Pearson correlation analysis between the SARA total scores and BBS (A), TUG (B), and TCT (C). Measuring tools were assessed immediately after the patients’ release from absolute bed rest (within 5 days from admission). SARA, Scale for the Assessment and Rating of Ataxia; BBS, Berg Balance Scale; TUG, Timed Up-andGo; TCT, Trunk Control Test. ***p<0.001.

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