Reply to the Letter to Editor

We are thankful to Dr. Asirvatham T for his/her critical and thoughtful reading the article and further giving the valuable comments. In response to the comments, it is to submit that the modified Rankin Scale (mRS) has been strongly recommended for the stroke trials.[1] Worldwide, mRS is being applied by not only in the rehabilitation trials but also to assess the global disability in pharmacological studies. The average poststroke duration was 40 months (chronic) in our study;[2] mRS is more appropriate during this stage. The study of Delfino et al. (2025), published now (after the completion of Pandian et al., 2024), has emphasized the use of utility-weighted mRS. The National Institutes of Health Stroke Scale is a recommended measure for the stroke severity considering arterial involvement, primarily in the acute stage but not for the global disability.[1,3] Montreal Cognitive Assessment (MoCA) is a recommended measure of cognitive assessment in stroke.[4] In the last few decades, this measure was commonly used in numerous stroke rehabilitation trials. MoCA has also been recommended for stroke subjects with aphasia.[5] In the present study (Pandian et al., 2024), the subjects with severe communication deficits were one of the exclusion criteria. In conclusion, the stroke-related measure of disability was selected considering the global application of the tool. Similarly, the measure of cognition was applied in view of the evidence, applicability, and also considering the chronicity of stroke subjects in our study. Financial Support and Sponsorship Nil. Conflicts of Interest There are no conflicts of interest.