What is the purpose and usage of the Sins (Stroke risk assessment) tool in clinical settings?

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SINS Risk Assessment Tool

The term "SINS" in the context you're asking about does not refer to a stroke risk assessment tool, but rather to the Screening Instrument for Neuropsychological Impairment in Stroke—a bedside cognitive screening tool developed by physiotherapists to assess perceptual and cognitive dysfunction in stroke patients. 1

What SINS Actually Measures

The SINS is designed to screen for neuropsychological deficits related to functional activities in stroke patients, not to predict stroke risk. 1 The instrument evaluates three primary domains:

  • Aphasia (language dysfunction) 1
  • Apraxia (motor planning deficits) 1
  • Visuocognitive dysfunction (visual-spatial and cognitive impairments) 1

Clinical Application

The SINS is administered at the bedside and is specifically designed to be brief and less exhausting for patients in the early post-stroke phase compared to comprehensive neuropsychological testing. 1 It demonstrates:

  • High sensitivity for detecting cognitive dysfunction when compared to more comprehensive reference methods 1
  • High specificity maintained at sensitivity levels appropriate for screening 1
  • Comparable ability to detect changes in cognitive function over time (first year post-stroke) as more time-consuming assessment batteries 1

The tool is typically incorporated into the general physiotherapy assessment of stroke patients and can be used for serial evaluations at 10 days and 12 months post-stroke. 1

Important Distinction: Stroke Risk Assessment Tools

If you're looking for tools to assess stroke risk (rather than post-stroke cognitive impairment), the appropriate instruments include:

  • Framingham Stroke Profile (FSP) for primary prevention, which calculates 10-year stroke risk using age, systolic blood pressure, diabetes, smoking, cardiovascular disease, atrial fibrillation, and left ventricular hypertrophy 2, 3
  • CHA2DS2-VASc score for stroke risk in atrial fibrillation patients 3
  • NIH Stroke Scale (NIHSS) for acute stroke severity assessment 3

Each patient should undergo stroke risk assessment using validated tools like the FSP, which helps identify individuals who could benefit from therapeutic interventions beyond single risk factor treatment. 2

References

Research

Validation of the screening instrument for neuropsychological impairment in stroke.

Physiotherapy research international : the journal for researchers and clinicians in physical therapy, 1998

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Clinical Calculators for Stroke Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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