Table 5.

Structured interview of modified Rankin Score (mRS-SI): an English translation of the French-validated mRS-SI

mRS-SI 5	Bedridden: ‘Is the person bedridden?’
	- The patient is unable to walk even with another person’s assistance.	Yes □ No □
	- If placed in a wheelchair, unable to self-propel effectively.
	- May frequently be incontinent.
	- Requires nearly constant care (provided by either a trained or untrained caregiver): someone needs to be available nearly at all times.
mRS-SI 4	Assistance to walk: ‘Is another person’s assistance essential for walking?’
	- Requiring another person’s assistance means needing another person to be always present when walking, including indoors around house or ward, to provide physical help, verbal instruction, or supervision.	Yes □ No □
	- Patients who use physical aids to walk (stick, walker) but do not require another person’s help, are NOT rated as requiring assistance to walk.
	- For patients who use wheelchairs, patient needs another person’s assistance to transfer into and out of chair, but can self-propel effectively without assistance.
mRS-SI 3	Assistance to look after own affairs1: “Could the patient live alone for 1 week if he/she absolutely had to?”
3.1	- Is assistance essential for preparing a simple meal?	Yes □ No □
3.2	- Is assistance essential for basic household chores?	Yes □ No □
3.3	- Is assistance essential for looking after household expenses and to manage day-today purchases?	Yes □ No □
3.4	- Is assistance essential for local travel and transportation?	Yes □ No □
3.5	- Is assistance essential for taking medication in correct dosages at correct time (includes preparation in advance, recall and supervision)?	Yes □ No □
3.6	- Telephone use: Is assistance essential for look up and dial numbers?	Yes □ No □
mRS-SI 2	Limitations in participation in usual duties and activities: “has there been a change in the person’s ability to work or look after others or participate to leisure activities as compared with prestroke status? This supposes that it is due to the new stroke itself.”
2.1	- Has the stroke substantially reduced the person’s ability to work or, for a student, to study? (Change from full-time to part-time, change in level of responsibility, or unable to work at all).	Yes □ No □
2.2	- Has the new stroke substantially reduced the person’s ability to look after family at home?	Yes □ No □
2.3	- Has the new stroke reduced the person’s regular free-time activities2?	Yes □ No □
2.4	- Is this reduction in activity related to a physical/medical problem other than the stroke? If yes which one? Details:	Yes □ No □
mRS-SI 1	Persisting symptoms as a result of the stroke: “Does the patient have any symptoms resulting from the new stroke?” “Does the person have:”
	- Difficulty reading or writing?	Yes □ No □
	- Difficulty speaking or finding the right word?	Yes □ No □
	- Problems with balance or coordination?	Yes □ No □
	- Visual problems as a result of the stroke?	Yes □ No □
	- Numbness (face, arms, legs, hands, feet)?	Yes □ No □
	- Weakness or loss of movement (face, arms, legs, hands, feet)?	Yes □ No □
	- Difficulty with swallowing	Yes □ No □
	- Sleeping difficulty?	Yes □ No □
	- Headaches as a result of stroke?	Yes □ No □
	- Otherwise unexplained reduction of activities, anxiety, depressive mood, or sadness repetitive concerns (especially about his/her health or situation)?	Yes □ No □
	- Loss of consciousness?	Yes □ No □
	- Other symptoms? Details:	Yes □ No □

1. Assistance includes physical help, verbal instructions, or supervision by others

2. Social and leisure activities include activities outside the home or at home; Activities outside the home: going to the coffee shop, bar, restaurant, club, church, cinema, visiting friends, going for walks; Activities at home: involving “active” participation including knitting, sewing, painting, games, reading books, home improvements

Procedure: Examiners had to read each proposal to the patient and caregiver and when impairment was detected, the corresponding Rankin grade had to be selected. The examiner might also gather data from other sources, such as records, nurse notes, and medical files. The examiner was instructed to rate what the patient actually did. The only exceptions concerned situations where the patient could clearly perform the activity in a fully independent manner but it was not performed for contextual reasons: patients able to work but not returning to work because the stroke occurred just before retirement (early retirement); patient able to perform basic activities but the carer prefers to do them because of time pressure; patient not confronted with specific activities (complex financial activities, transportation, meal preparation) since hospital discharge