London Handicap Scale

Acute Stroke: (Hershkovitz et al., 2004; n = 207; mean age for men 71 (7) and women 69 (10) years; assessed 4 to 12 weeks post stroke)

Acute Stroke: (Jenkinson et al., 2000, n = 323, mean age = 74 (11) years)

• Mean score = 63.9 (SD 16.4, range 15.3–100)

Chronic Stroke: (Gall et al., 2009; n = 351; mean age = 75 (14) years; assessed 5 years post stroke)

• Mean (SD) The London Handicap Scale (LHS); 73 (21), range; LHS range 16 – 100.

Chronic Stroke: (Harwood et al., 1994; n = 89; mean age - 71; mailed survey 12 months post-stroke)

• Excellent agreement between assessments (approximately 2 weeks apart; mean difference between assessments = 0.01; SD = 0.09)

• Excellent correlation between assessments (r = 0.91)

Acute Stroke: 

(Jenkinson et al., 2000; n = 323; mean age = 74 (11) years)

• Excellent internal consistency (Cronbach’s alpha = 0.83)

(Chau et al., 2009; n = 188; mean age = 71.7 (10.2) years)

• Excellent internal consistency (Cronbach's alpha = 0.80) at 12 months post stroke.

Chronic Stroke: Concurrent Validity (Harwood et al., 1994)

• Adequate correlation with the Barthel Index (r = 0.56)

• Excellent correlation with the Nottingham Extended Activities for Daily Living total score (r = 0.69)

• Excellent to Adequate correlation with the Nottingham Extended Activities for Daily Living (Subscales) - Mobility r = 0.66), Kitchen (r = 0.52), Domestic (r = 0.62), Leisure (r = 0.64)

• Adequate correlation with the Nottingham Health Profile total score (r = -0.42)

• Adequate  to poor correlation with the Nottingham Health Profile (subscales) - Physical mobility (r = -0.52), Energy (r = -0.36), Pain (r = -0.31), Social isolation (r = -0.30), Emotion (r = -0.28), Sleep (r = -0.19)

• Adequate correlation with the Geriatric Depression Scale (r = -0.42)

Acute Stroke: (Hershkovitz et al., 2004) Predictive Validity; LHS discharge and Admission Scores  

• Adequate correlation with the FIM (r = -0.522; p < 0.001)

• Adequate correlation with the Nottingham Index (r = -0.458; p < 0.001)

• Adequate correlation with the Timed Get Up and Go (r = 0.350; p = .002)

Chronic Stroke: (Jenkinson et al., 2000)

• Excellent correlations with the Barthel at 3 months (r = 0.8) and 12 months (r = 0.7) post stroke (Strum et al, 2002).

Community Dwelling: Chronic-Stroke: (Kutlay et al., 2010)

Community Dwelling: Chronic-Stroke: (Cardol et al., 2001); 5 Diagnostic Groups – Respectively, neuromuscular disease, stroke, spinal cord injury (SCI), rheumatoid arthritis, or fibromyalgia; Discriminant Validity

• Correlations between all domains of the IPAQ and the domains “economic self-sufficiency” and “orientation” (LHS) were poor (range, r= -.01 to -.29), demonstrating discriminant validity.

The LHS is based on the ICIDH classification of Disablement developed by the World Health Organization (WHO).

Goonetilleke (1995) reports acceptable face validity.

Acute Stroke: (Harwood & Ebrahim, 2000; n = 76; re-tested on 37; mean age = 83 years; day hospital patients)

The LHS was more sensitive in measuring day hospital outcomes than the Barthel Index

Adequate responsiveness for inpatient rehabilitation for multiple sclerosis (Freeman et al., 1997).

Adequate responsiveness for the scale after hip and knee replacement (Harwood & Ebrahim, 1995)

Community Dwelling Adults: (Dubuc et al., 2004) Concurrent Validity

• Excellent correlation between the LHS and the Late-Life Function and Disability Instrument's (LLFDI) disability limitation (r = 0.66; p < 0.0001)

• Adequate correlation between the LHS and and Disability frequency (r = 0.47, p < 0.001) scores.

Community Dwelling Adults: (Dubuc at al., 2004)

• Poor ceiling effects were observed for the LHS (31%).

Medically Ill Elderly: (Shah et al., 2000; 6–8 months follow-up)

• Only the LHS scores (p = 0.024) independently predicted mortality*

*Association between low LHS scores and mortality is consistent with previous reports.

Very Preterm Birth and/or Very Low Birth Weight – Transition into Adulthood: (Lunenburg et al., 2013; assessed at 19 years and 28 years of age, n = 314 for participants age 19; n=957 for participants age 28).

# MI: After multiple imputation.

Young Adults with Disabilities: (Van Dommelen et al., 2014).

• Higher catch-up growth in head circumference (HC) was associated with less disabilities in young adulthood according to the LHS.

Dementia – Parkinsonism Severity: (Coelho et al., 2015; n = 50; mean age = 74.1 (7.0) years; mean duration of disease = 17.94 (6.3) years).

• Mean (SD) The London Handicap Scale (LHS); 0.33 (0.15).

Dementia – Parkinsonism Severity: (Coelho et al., 2015) Predictive Validity; Total LHS Scores

• Adequate correlation with the Unified Parkinson’s Disease Rating Scale (UPDRS) part I (r = −0.57; p < 0.000)

• Adequate correlation with the Hoehn & Yahr (H&Y) stage in ‘off’ (r = −0.47; p = 0.001)

Dementia – Parkinsonism Severity: (Coelho et al., 2014)

• The scores had a normal distribution and no obvious ceiling or floor effects.

• Maximum score = 1.00 (sum of all “no disadvantage” value is 0.544 + 0.456; indicating normal function)

• Minimum score = 0.00 (sum of all “most severe disadvantage” value is -0.456 which when added to 0.456; indicating total disability)

The LHS is based on the international classification of impairments, disabilities and handicaps (ICIDH) developed by the World Health Organization (WHO).