STREAM-STROKE REHABILITATION ASSESSMENT OF MOVEMENT
PATIENT LAST NAME: DATE OF BIRTH:
PATIENT FIRST NAME: DATE:
SR GENERAL COMMENTS SCORE SCORE SCORE SCORE
NO. DATE DATE DATE DATE
1 2 3 4
1. SUPINE-
A. PROTRACTS SCAPULA IN SUPINE.
“LIFT YOUR SHOULDER BLADE SO THAT
YOUR HAND MOVES TOWARDS THE CEILING”
NOTE:THERAPIST STABILIZES ARM WITH
SHOULDER 90 DEGREE FLEXED AND ELBOW /2
ETENDED.
B. EXTENDS ELBOW IN SUPINE(STARTING WITH
ELBOW FULLY FLEXED).
“LIFT YOUR HAND TOWARDS THE
CEILING,STRAIGHTENING YOUR ELBOW AS
MUCH AS YOU CAN “
NOTE:THERAPIST STABILIZES ARM WITH
SHOULDER 90 DEGREE FLEXED,STRONG /2
ASSOCIATED SHOULDER EXTENSION OR
ABDUCTION.
C. FLEXES HIP AND KNEE IN SUPINE(ATTAINS
HALF CROOK LYING).
/2
“BEND YOU’RE YOUR HIP AND KNEE SO THAT
YOUR FOOT RESTES FLAT ON BED”
D. ROLLS ONTO SIDE(STARTING FROM SUPINE).
“ROLL ONTO YOUR SIDE”
NOTE:MAY ROLL ONTO EITHER SIDE,PULLING /3
WITH ARMS TO TURN OVER.
E. RAISES HIP OFF BED IN CROOK
LYING(BRIDGING).
“LIFT YOUR HIP AS HIGH AS YOU CAN”
NOTE:THERAPIST MAY STABILIZE FOOT,BUT /3
IF KNEE PUSHES STRONGLY INTO
EXTENSION WITH BRIDGING(SCORE 1a OR
1c),IF REQUIRES AID(EXTERNAL OR FROM
THERAPIST)TO MAINTAIN KNEES IN MIDLINE.
F. MOVES FROM LYING SUPINE TO
SITTING(WITH FEET ON THE FLOOR).
“SIT UP AND PLACE YOUR FEET ON THE
FLOOR” /3
NOTE:MAY SIT UP TO EITHER SIDE USING
ANY FUNCTIONAL AND SAFE
METHOD,LONGER THAN 20 SEC(SCORE1a OR
1c),PULLING UP USING BEDRAIL OR EDGE OF
PLINTH.
2. SITTING-
A. SHRUG SHOULDERS(SCAPULAR ELEVATION).
“SHRUG YOUR SHOULDERS AS HIGH AS YOU
/2
CAN”
NOTE:BOTH SHOULDERS ARE SHRUGGED
SIMULTANEOUSLY.
B. RAISES HAND TO TOUCH TOP OF HEAD.
“RAISE YOUR HAND TO TOUCH THE TOP OF
/2
YOUR HEAD”
C. PLACES HAND ON SACRUM.
“REACH BEHIND YOUR BACK AND AS FAR
ACROSS TOWARD THE OTHER SIDE AS YOU
CAN” /2
D. RAISES ARM OVERHEAD TO FULLEST
ELEVATION.
/2
“REACH YOUR HAND AS HIGH AS YOU CAN
TOWARDS THE CELLING”
E. SUPINATES AND PRONATES
FOREARM(ELBOW FLEXED AT 90 DEGREE).
“KEEPING YOUR ELBOW BENT AND CLOSE TO
YOUR SIDE,TURN YOUR FOREARM OVER SO /2
THAT YOUR PALM FACES UP,THEN TURN
YOUR FOREARM OVER SO THAT YOUR PALM
FACES DOWN”
NOTE:MOVEMENT IN ONE DIRECTION
ONLY(SCORE1a OR 1b).
F. CLOSES HAND FROM FULLY OPENED
POSITION.
“MAKE A FIST,KEEPING YOUR THUMB ON THE
OUTSIDE” /2
NOTE:MUST EXTEND WRIST SLIGHTLY(i.e
WRIST CROOKED)TO OBTAIN FULL
MARKS,FULL FIST WITH LACK OF WRIST
EXTENSION MOVEMENT(SCORE 1a OR 1b).
G. OPENS HAND FROM FULLY CLOSED /2
POSITION.
“NOW OPEN YOUR HAND ALL THE WAY”
H. OPPOSES THUMB TO INDEX FINGER(TIP TP /2
TIP)
“MAKE A CIRCLE WITH YOUR THUMB AND
INDEX FINGER”
I. FLEXES HIP IN SITTING. /2
“LIFT YOUR KNEE AS HIGH AS YOU CAN”
J. EXTENDS KNEE IN SITTING. /2
“STRAIGHTEN YOUR KNEE BY LIFTING YOUR
FOOT UP”
K. FLEXES KNEE IN SITTING.
“SLIDE YOUR FOOT BACK UNDER YOU AS FAR
AS YOU CAN”
NOTE:START WITH AFFECTED FOOT /2
FORWARD(HEEL IN LINES WITH TOES OF
OTHER FOOT).
L. DORSIFLEXES ANKLE IN SITTING.
“KEEP YOUR HEEL ON GROUND AND LIFT
YOUR TOES OFF THE FLOOR AS FAR AS YOU
CAN”
NOTE:AFFECTED FOOT IS PLACED SLIGHTLY /2
FORWARD(HEEL IN LINES WITH TOES OF
OTHER FOOT).
M. PLANTARFLEXES ANKLE IN SITTING.
“KEEP YOUR TOES ON THE GROUND AND LIFT
/2
YOUR HEEL OFF THE FLOOR AS FAR AS YOU
CAN”
N. EXTENDS KNEE IN SITTING.
“STRAIGHTEN YOUR KNEE AND BRING YOUR
/2
TOES TOWARDS YOU”
NOTE:EXTENSION OF KNEE WITHOUT
DORSIFLEXION OF ANKLE(SCORE 1a OR 1b).
O. RISES TO STANDING FROM SITTING.
“STAND UP,TRY TO TAKE EQUAL WEIGHT ON
BOTH LEGS”
NOTE:PUSHING UP WITH HAND TO
STAND(SCORE 2),ASYMMETRY SUCH AS /3
TRUNK LEAN,TRENDLENBURG POSITION,HIP
RETRACTION,EXCESSIVE FLEXION OR
EXTENSION OF AFFECTED KNEE(SCORE 1a
OR 1c).
3. STANDING-
A. MAINTAIN STANDING FOR 20 COUNTS. /2
“STAND ON THE SPOT WHILE I COUNT 20”
B. ABDUCTS AFFECTED HIP WITH KNEE
EXTENDED.
“KEEP YOUR KNEE STRAIGHT AND YOUR HIP /2
LEVEL,AND RAISE YOUR LEG TO THE SIDE”
C. FLEXES AFFECTED KNEE WITH HIP
EXTENDED.
/2
“KEEP YOUR HIP STRAIGHT,BEND YOUR KNEE
BACK AND BRING YOUR HEEL TOWARDS
YOUR BOTTOM”
D. DORSIFLEXES AFFECTED ANKLE WITH KNEE
EXTENDED.
“KEEP YOUR HEEL ON GROUND AND LIFT
YOUR TOES OFF THE FLOOR AS FAR AS YOU
CAN” /2
NOTE:AFFECTED FOOT IS PLACED SLIGHTLY
FORWARS IN POSITION OF A SMALL
STEP(HEEL IN LINE WITH TOES OF OTHER
FOOT).
4. STANDING AND WALKING-
A. PLEASE AFFECT FOOT ONTO FIRST STEP(OR
STOOL 18 CM HIGH).
“LIFT YOUR FOOT AND PLACE IT ONTO THE /3
FIRST STEP(STOOL)IN FRONT OF YOU”
NOTE:RETURNING THE FOOT TO THE
GROUND IS NOT SCORED,USE OF HANDRAIL.
B. TAKES 3 STEPS SIDEWAYS TO AFFECTED
SIDE.
“TAKE 3 AVERAGW SIZED STEPS SIDEWAYS /3
TOWARDS YOUR WEAK SIDE”
C. TAKE 3 STEPS BACKWARDS(1/2 GAIT CYCLE).
“TAKE 3 AVERAGE SIZED STEPS
BACKWARDS,PLACING ONE FOOT BEHIND /3
THE OTHERS”
D. WALK 10 METERS INDOORS(ON
SMOOTH,OBSTACLE SURFACE).
“WALK IN STRAIGHT LINE OVER TO…(A /3
SPECIFIED POINT 10 METERS AWAY)”
NOTE:ORTHOTIC(SCORE2),LONGER THAN 20
SEC(SCORE 1c).
E. WALKS DOWN 3 STAIRS ALTERNATING FEET.
“WALK DOWN 3 STAIRS,PLACED ONLY ONE
/3
FOOT AT A TIME ON EACH STEP IF YOU CAN”
NOTE:HANDRAIL(SCORE 2),NON-
ALTERNATING FEET(SCORE 1a OR 1c).
TOTAL SCORE…..70
[Link] MOVEMENT OF THE LIMBS
0=UNABLE TO PERFORM THE TEST MOVEMENT THROUGH ANY APPRRECIABLE RANGE
(INCLUDES FLICKER OR SLIGHT MOVEMENT).
1(A)=ABLE TO PERFORM ONLY PART OF THE MOVEMENT,AND WITH MARKED DEVIATION
FROM NORMAL PATTERN.
1(B)=ABLE TO PERFORM ONLY PART OF THE MOVEMENT,BUT IN MANNER THAT IS
COMPORABLE TO THE UNAFFECTED SIDE.
1(C)=ABLE TO COMPLETE THE MOVEMENT,BUT ONLY WITH MARKED DEVIATION FROM
NORMALL PATTERN.
2=ABLE TO COMPLETE THE MOVEMENT IN A MANNER THAT IS COMPORABLE TO THE
UNAFFECTED SIDE.
ACTIVITY NON TESTED(SPECIFY WHY ROM,PAIN,OTHER REASON).
[Link] MOBILITY
0=UNABLE TO PERFORM THE TEST ACTIVITY THROUGH ANY APPRECIABLE RANGE(i.e
MINIMAL ACTIVE PARTICIPATION).
1(A)=ABLE TO PERFORM ONLY PART F THE ACTIVITY INDEPENDENTLY(REQUIRES PARTIAL
ASSISTANCE OR STABILIZATION TO COMPLETE),WITH OR WITHOUT AN AID,AND WITH
MARKED DEVIATION FROM NORMAL PATTERN.
1(B)=ABLE TO PERFORM ONLY PART OF THE ACTIVITY INDEPENDENTLY(REQUIRES PARTIAL
ASSISTANCE OR STABILIZATION TO COMPLETE),WITH OR WITHOUT AID,BUT WITH A
GROSSLY NORMAL MOVEMENT PATTERN.
1(C)=ABLE TO COMPLETE THE ACTIVITY INDEPENDENTLY,WITH OR WITHOUT AN AID,BUT
ONLY WITH MARKED DEVIATION FROM NORMAL PATTERN.
2=ABLE TO COMPLETE THE ACTIVITY INDEPENDENTLY WITH A GROSSLY NORMAL
MOVEMENT PATTERN,BUT REQUIRES AN AID.
3=ABLE TO COMPLETE THE ACTIVITY INDEPENDENTLY WITH A GROSSLY NORMAL
PATTERN,WITHOUT AN AID.
ACTIVITY NON TESTED(SPECIFY WHY ROM,PAIN,OTHER REASON)
AMPLITUDE OF ACTIVE MOVEMENT:
MOVEMENT NONE PARTIAL COMPLETE
QUALITY
MARKED O 1a 1c
DEVIATION
GROSSLY 0 1b 2(3)
NORMAL