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European Journal of Physical and Rehabilitation Medicine 2021 October;57(5):669-76

DOI: 10.23736/S1973-9087.21.06638-7

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

Redefining a minimal assessment protocol for stroke rehabilitation: the new “Protocollo di Minima per l’ICtus” (PMIC2020)

Francesca CECCHI 1, Anna CASSIO 2, Susanna LAVEZZI 3, Federico SCARPONI 4, Giordano GATTA 5, Andrea MONTIS 6, Chiara BERNUCCI 7, Marco FRANCESCHINI 8, Stefano BARGELLESI 9 , Stefano PAOLUCCI 10, Mariangela TARICCO 11

1 Department of Experimental and Clinical Medicine, IRCCS Fondazione Don Carlo Gnocchi Scientific Institute, University of Florence, Florence, Italy; 2 Physical and Rehabilitation Medicine, AUSL Piacenza, Piacenza, Italy; 3 Department of Neuroscience and Rehabilitation, Ferrara University Hospital, Ferrara, Italy; 4 Unit of Brain Injury, Department of Rehabilitation, San Giovanni Battista Hospital, Foligno, Perugia, Italy; 5 Italian Society of Physical and Rehabilitation Medicine (SIMFER), Ravenna, Italy; 6 Department of Neurorehabilitation, San Martino Hospital, ASSL Oristano, Oristano, Italy; 7 Department of Primary Care - Community Medicine, Infermi Hospital, AUSL of Romagna, Rimini, Italy; 8 IRCCS San Raffaele, Rome, Italy; 9 Physical and Rehabilitation Medicine-Severe Brain Injury and Spinal Cord Unit, Ca’ Foncello Treviso Hospital, AULSS 2 Marca Trevigiana, Treviso, Italy; 10 IRCCS S. Lucia Foundation, Rome, Italy; 11 Unit of Physical and Rehabilitation Medicine, AOU S. Orsola, Bologna, Italy



The use of standardized assessment protocols is strongly recommended to identify patient’s needs, outcomes, and predictors of response to specific interventions in Stroke rehabilitation. In 2008, the Italian Society of Physical and Rehabilitation Medicine (SIMFER) published the minimal protocol for the person with stroke (“Protocollo di Minima per l’ICtus” [PMIC]), in reference to the International classification of Functioning, Disability and Health. In 2019, the SIMFER appointed a working group to provide a revised, updated version in line with the most recent literature and suitable for all rehabilitation settings: the PMIC2020. Descriptive study based on the consensus of a panel of experts. The study setting includes all the rehabilitation settings. The population included is represented by stroke survivors with disability. The coordinator of the SIMFER National Stroke Section appointed the working group, including the 8 Stroke Section board members, and 4 more experts (3 physiatrists; 1 neurologist). An extensive revision of the international literature on stroke assessment recommendations was performed; each proposed change from PMIC was written and motivated, discussed and voted. The PMIC2020 is a single form, to be administered at any time of the rehabilitation pathway, including a minimum set of variables, consisting of a demographic/anamnestic section, and a clinical/functional assessment section. Newly introduced tools included measures of malnutrition (BMI<18.5); pain in verbal and non-verbal patients (Numeric Rating Scale-pain, Pain Assessment in Advanced Dementia Scale); neurological impairment (National Institute of Health-Stroke Scale); activity (Modified Barthel Index, Short Physical Performance Battery); and participation (Frenchay Activity Index). The PMIC2020 provides an updated tool for the multidimensional rehabilitation assessment of the stroke patient, at any stage of the rehabilitation pathway, aiming at a shared minimum set of variables defining patient’s needs and at defined outcomes across different rehabilitation facilities and settings. The PMIC2020 identifies patient’s needs, outcomes, and predictors of response to specific interventions in Stroke rehabilitation and provide ground for a highly needed Stroke Registry.


KEY WORDS: Stroke; Stroke rehabilitation; Symptom assessment; Patient outcome assessment; Practice guideline; Process assessment, health care

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