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If any one of the three tests shows abnormal findings, the patient may be having a stroke and should be transported to a hospital as soon as possible. The CPSS was derived from the National Institutes of Health Stroke Scale developed in 1997 at the University of Cincinnati Medical Center for prehospital use. [2]
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The instruments at this time with most evidence of validity were the Cincinnati Prehospital Stroke Scale (CPSS) and the Los Angeles Prehospital Stroke Screen (LAPSS). [ 3 ] Studies using FAST have demonstrated variable diagnostic accuracy of strokes by paramedics and emergency medical technicians with positive predictive values between 64% and 77%.
[38] [39] Other scales for prehospital detection of stroke include the Los Angeles Prehospital Stroke Screen (LAPSS) [40] and the Cincinnati Prehospital Stroke Scale (CPSS), [41] on which the FAST method was based. [42] Use of these scales is recommended by professional guidelines. [43]
Prior to the NIHSS, during the late 1980s, several stroke-deficit rating scales were in use (e.g., University of Cincinnati scale, Canadian neurological scale, the Edinburgh-2 coma scale, and the Oxbury initial severity scale). The NIHSS is composed of 11 items, each of which scores a specific ability between a 0 and 4.
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Fugl-Meyer Assessment (FMA) scale is an index to assess the sensorimotor impairment in individuals who have had stroke. [1] This scale was first proposed by Axel Fugl-Meyer and his colleagues as a standardized assessment test for post-stroke recovery in their paper titled The post-stroke hemiplegic patient: A method for evaluation of physical performance.