Table 1.

Details of the National Institute of Health Stroke Scale items and the definition of the four body system impairments; consciousness, cognition, motor and sensory impairments.

National Institute of Health Stroke Scale item label		Score = 0	Score = 1	Score = 2	Score = 3	Score = 4
Body system impairment = consciousness (score > 1)
1a	LOC responsiveness	Alert, responsive	Not alert but verbally arousable or aroused by minor stimulation to obey, answer, or respond	Only responsive to repeated/strong/painful stimuli	Totally unresponsive, except reflexes/Areflexic
Body system impairment = cognition (any > 0)
1b	LOC orientation	Correctly answers questions	Correctly answers one question	Nether answer correct
1c	LOC commands	Correctly performs tasks	Correctly performs one task	Neither task performed
9	Language/communication	Normal, no speech deficit	Detectable fluency loss, though still able to extract information	Speech fragmented and unable to extract content	Unable to speak/understand speech
11	Extinction and inattention	Normal, correctly answers questions	Inattention on one side/modality (visual, tactile, auditory, spatial)	Does not recognise stimuli in multiple modality on same side
Body system impairment = motor (any > 0)
4	Facial palsy	Normal, symmetrical movement	Function less normal, flattened nasolabial fold or minor smile asymmetry	Partial Paralysis, paralysis in lower face	Total paralysis upper and lower portion of one side
5a,5b	Motor arm	Normal	Patient can hold position against gravity but drifts immediately	Can hold arm up but drops within 10 seconds	Unable to lift but can move arm in some form	No movement
6a,6b	Motor leg	Normal	Can hold position against gravity but drifts within 5 seconds	Can hold leg up but drops within 10 seconds	Unable to lift but can move leg in some form	No movement
7	Limb ataxia	Normal coordination; smooth, accurate movement	ataxia present In limb	Severe Ataxia (both limbs)
10	Speech/dysarthria	Normal, clear, smooth speech	some slurring speech	cannot be understood
Body system impairment = sensory (any > 0)
2	Best Gaze/ Horizontal Eye Movement	Normal, able to follow pen both sides	Partial gaze palsy, abnormal in one/both eyes	Total gaze paresis, gaze fixed to once side
3	Visual field test	No vision loss	Partial hemianopia or complete quadrantanopia	No visual stimulus in 1/2 of visual field	Bilateral blindness from any cause
8	Sensory (pinprick)	Feels pinprick equally both sides	Patient feels pinprick, duller on one side	Total sensory loss on one side	Not aware of being touched in all unilateral extremities