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Neurology International
Volume 17
Issue 8
10.3390/neurolint17080116
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Article

Reliability and Validity of the Lowenstein Communication Scale

by
Anna Oksamitni
1,2,
Hiela Lehrer
1,
Ilana Gelernter
2,
Michal Scharf
1,
Lilach Front
1,
Olga Bendit-Goldenberg
1,
Amiram Catz
1,2,* and
Elena Aidinoff
1,2
1
The Intensive Care for Consciousness Rehabilitation Department, the Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana 4355840, Israel
2
The Department of Rehabilitation, the School of Mathematics, Tel Aviv University, Tel Aviv 6139001, Israel
*
Author to whom correspondence should be addressed.
Neurol. Int. 2025, 17(8), 116; https://doi.org/10.3390/neurolint17080116
Submission received: 30 May 2025 / Revised: 7 July 2025 / Accepted: 23 July 2025 / Published: 29 July 2025
(This article belongs to the Section Brain Tumor and Brain Injury)
Versions Notes

Abstract

Background/Objectives: The Lowenstein Communication Scale (LCS) is a tool for the evaluation of communicative performance in patients with disorders of consciousness (DOC). This study investigated the reliability and validity of the LCS. Methods: We evaluated 23 inpatients with unresponsive wakefulness syndrome (UWS) and 18 in a minimally conscious state (MCS), at admission to a Consciousness Rehabilitation Department and one month later. The evaluations included assessments of LCS by two raters, and of the Coma Recovery Scale–Revised (CRS-R) by one rater. Results: Total inter-rater agreement in LCS task scoring was found in 58–100% of the patients. Cohen’s kappa values were >0.6 for most tasks. High correlations were found between the two raters on total scores and most subscales (r = 0.599–1.000, p < 0.001), and the differences between them were small. LCS subscales and total score intraclass correlations (ICC) were high. Internal consistency was acceptable (Cronbach’s α > 0.7) for most LCS subscales and total scores. Moderate to strong correlations were found between LCS and CRS-R scores (r = 0.554–0.949, p < 0.05), and the difference in responsiveness between LCS and CRS-R was non-significant. Conclusions: The findings indicate that the LCS is reliable and valid, making it a valuable clinical and research assessment tool for patients with DOC.
Keywords: minimally conscious state; unresponsiveness wakefulness syndrome; consciousness disorders; reliability; validity; assessment of communication minimally conscious state; unresponsiveness wakefulness syndrome; consciousness disorders; reliability; validity; assessment of communication

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MDPI and ACS Style

Oksamitni, A.; Lehrer, H.; Gelernter, I.; Scharf, M.; Front, L.; Bendit-Goldenberg, O.; Catz, A.; Aidinoff, E. Reliability and Validity of the Lowenstein Communication Scale. Neurol. Int. 2025, 17, 116. https://doi.org/10.3390/neurolint17080116

AMA Style

Oksamitni A, Lehrer H, Gelernter I, Scharf M, Front L, Bendit-Goldenberg O, Catz A, Aidinoff E. Reliability and Validity of the Lowenstein Communication Scale. Neurology International. 2025; 17(8):116. https://doi.org/10.3390/neurolint17080116

Chicago/Turabian Style

Oksamitni, Anna, Hiela Lehrer, Ilana Gelernter, Michal Scharf, Lilach Front, Olga Bendit-Goldenberg, Amiram Catz, and Elena Aidinoff. 2025. "Reliability and Validity of the Lowenstein Communication Scale" Neurology International 17, no. 8: 116. https://doi.org/10.3390/neurolint17080116

APA Style

Oksamitni, A., Lehrer, H., Gelernter, I., Scharf, M., Front, L., Bendit-Goldenberg, O., Catz, A., & Aidinoff, E. (2025). Reliability and Validity of the Lowenstein Communication Scale. Neurology International, 17(8), 116. https://doi.org/10.3390/neurolint17080116

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