The Rancho Los Amigos Scale (RLAS), a.k.a. the Rancho Los Amigos Levels of Cognitive Functioning Scale (LOCF) or Rancho Scale, is a medical scale used to assess individuals after a
closed head injury Closed-head injury is a type of traumatic brain injury in which the skull and dura mater remain intact. Closed-head injuries are the leading cause of death in children under 4 years old and the most common cause of physical disability and cognitive ...
, including
traumatic brain injury
A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity (ranging from mild traumatic brain injury TBI/concussionto severe traumatic br ...
, based on cognitive and behavioural presentations as they emerge from
coma.
[Rancho Los Amigos National Rehabilitation Center. (1 March 2011). ''The Rancho Levels of Cognitive Functioning''. Retrieved May 15, 2011, from https://web.archive.org/web/20110514024558/http://rancho.org/Research_RanchoLevels.aspx] It is named after the
Rancho Los Amigos National Rehabilitation Center
Rancho Los Amigos National Rehabilitation Center is a rehabilitation hospital located in Downey, California, United States. Its name in Spanish means 'Friends' Ranch'.
History
Overview
Rancho Los Amigos National Rehabilitation Center, or Ranc ...
, located in
Downey, California, United States in
Los Angeles County.
After being assessed based on the LOCF, individuals with brain injury receive a score from one to eight. A score of one represents non-responsive cognitive functioning, whereas a score of eight represents purposeful and appropriate functioning.
[Fulk, G. D. (2007). Traumatic Brain Injury. In S. B. O’Sullivan & T. J. Schmitz (Eds.), ''Physical Rehabilitation'' (5th ed., pp. 895-935). Philadelphia, PA: F. A. Davis Company.]
Each of the eight levels represents the typical sequential progression of recovery from brain damage. However, individuals progress at different rates and may plateau at any stage of recovery. These patients are scored based on combinations of the following criteria:
* responsiveness to stimuli
* ability to follow commands
* presence of non-purposeful behavior
*
cooperation
*
confusion
In medicine, confusion is the quality or state of being bewildered or unclear. The term "acute mental confusion"
*
attention to environment
* focus
* coherence of verbalization
* appropriateness of verbalizations and actions
*
memory recall
*
orientation
Orientation may refer to:
Positioning in physical space
* Map orientation, the relationship between directions on a map and compass directions
* Orientation (housing), the position of a building with respect to the sun, a concept in building de ...
*
judgement
Judgement (or US spelling judgment) is also known as ''adjudication'', which means the evaluation of evidence to make a decision. Judgement is also the ability to make considered decisions. The term has at least five distinct uses. Aristotle s ...
and
reasoning
LOCF scores are used by health care professionals for standardized communication about patient status and can be used by
physiatrists,
physical therapists
Physical therapy (PT), also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, management, prognosis, patien ...
,
occupational therapists
Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's abili ...
,
recreational therapists, and
speech language pathologists as the basis for treatment planning.
This eight-level scale was found to possess test-retest and interrater reliability as well as concurrent and predictive validity.
[Gouvier, W. D., Blanton, P. D., LaPorte, K. K., & Nepomuceno, C. (1987). Reliability and validity of the Disability Rating Scale and the Levels of Cognitive Functioning Scale in monitoring recovery from severe head injury. ''Archives of Physical Medicine and Rehabilitation'', 68(2), 94-97.] It is widely used clinically and is often paired with the
Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a clinical scale used to reliably measure a person's level of consciousness after a brain injury.
The GCS assesses a person based on their ability to perform eye movements, speak, and move their body. These thre ...
in health care facilities.
References
{{reflist
External links
Family Guide To The Rancho Levels of Cognitive Functioning- description of the scale at the Rancho Los Amigos National Rehabilitation Center
Neurology
Medical scales
Coma
Medical assessment and evaluation instruments