Makindo Medical Notes

Related Subjects: |Acute Stroke Assessment (ROSIER&NIHSS) |Causes of Stroke

Introduction

The Modified Oxford Handicap Scale (MOHS) is a clinical tool used to assess the degree of disability or dependence in daily activities for patients who have suffered a stroke or other neurological conditions. It is a simplified version of the original Oxford Handicap Scale, designed to provide a quick and practical measure of a patient's functional status. The scale ranges from 0 to 5, with higher scores indicating greater levels of disability.

Scale Description

• 0 - No symptoms: The patient has no neurological symptoms and is fully independent in all activities.
• 1 - Minor symptoms: The patient experiences minor symptoms but is able to carry out all usual duties and activities without significant limitations.
• 2 - Some restriction: The patient has slight disability, leading to some restrictions in lifestyle or daily activities but does not require assistance for personal needs.
• 3 - Dependent: The patient requires some help but is able to walk unassisted; they may need assistance with more complex tasks but can manage basic personal needs independently.
• 4 - Fully dependent: The patient is unable to attend to their own bodily needs without assistance and cannot walk unassisted; they are dependent on others for most or all daily care.
• 5 - Death: The patient has died.

Interpretation

• Scores 0-1: The patient has no significant disability and can perform normal activities without assistance.
• Score 2: The patient has mild disability but remains independent in personal care.
• Score 3: The patient has moderate disability, requiring some assistance but not fully dependent.
• Score 4: The patient has severe disability, requiring full assistance for daily living activities.
• Score 5: The patient is deceased.

Clinical Use

• Outcome Measurement: The MOHS is used to assess patient outcomes in clinical practice and research, particularly after stroke or neurological injury.
• Treatment Planning: Helps healthcare professionals determine the level of care, rehabilitation, and support services required.
• Prognostic Indicator: Higher scores may indicate a need for more intensive intervention and are associated with poorer prognosis.
• Communication Tool: Provides a standardized method for describing patient disability among healthcare providers.

Comparison with Other Scales

The MOHS is similar to other disability scales such as the Modified Rankin Scale (mRS) but is designed to be more straightforward and easier to administer. Both scales measure the level of functional independence, but the MOHS offers a simplified approach with fewer categories.

References

• van Swieten JC, Koudstaal PJ, Visser MC, Schouten HJ, van Gijn J. Interobserver agreement for the assessment of handicap in stroke patients. Stroke. 1988 May;19(5):604-7.
• Wade DT, Hewer RL. Functional abilities after stroke: measurement, natural history and prognosis. J Neurol Neurosurg Psychiatry. 1987 Feb;50(2):177-82.
• Duncan PW, Jorgensen HS, Wade DT. Outcome measures in acute stroke trials: a systematic review and some recommendations to improve practice. Stroke. 2000 Apr;31(6):1429-38.