The Stroke Impact Scale Version 2.0

Abstract

Background and Purpose-To be useful for clinical research, an outcome measure must be feasible to administer and have sound psychometric attributes, including reliability, validity, and sensitivity to change. This study characterizes the psychometric properties of the Stroke Impact Scale (SIS) Version 2.0. Methods-Version 2.0 of the SIS is a self-report measure that includes 64 items and assesses 8 domains (strength, hand function, ADL/IADL, mobility, communication, emotion, memory and thinking, and participation). Subjects with mild and moderate strokes completed the SIS at 1 month (nϭ91), at 3 months (nϭ80), and at 6 months after stroke (nϭ69). Twenty-five subjects had a replicate administration of the SIS 1 week after the 3-month or 6-month test. We evaluated internal consistency and test-retest reliability. The validity of the SIS domains was examined by comparing the SIS to existing stroke measures and by comparing differences in SIS scores across Rankin scale levels. The mixed model procedure was used to evaluate responsiveness of the SIS domain scores to change. Results-Each of the 8 domains met or approached the standard of 0.9 ␣-coefficient for comparing the same patients across time. The intraclass correlation coefficients for test-retest reliability of SIS domains ranged from 0.70 to 0.92, except for the emotion domain (0.57). When the domains were compared with established outcome measures, the correlations were moderate to strong (0.44 to 0.84). The participation domain was most strongly associated with SF-36 social role function. SIS domain scores discriminated across 4 Rankin levels. SIS domains are responsive to change due to ongoing recovery. Responsiveness to change is affected by stroke severity and time since stroke. Conclusions-This new, stroke-specific outcome measure is reliable, valid, and sensitive to change. We are optimistic about the utility of measure. More studies are required to evaluate the SIS in larger and more heterogeneous populations and to evaluate the feasibility and validity of proxy responses for the most severely impaired patients. (Stroke. 1999;30:2131-2140.)

Derivation and Validation of a Modified Short Form of the Stroke Impact Scale

“…The SIS has been suggested as the optimal PROM for this purpose as it has been shown to be reliable, valid, and sensitive to change 14. However, there are examples of clinical studies where SIS was used as an end‐point measure and, as a result of perceived burden, questionnaire return rates were so poor as to invalidate the study 15.…”

Forced Aerobic Exercise Enhances Motor Recovery After Stroke: A Case Report

“…Outcomes used to measure UE motor function were the Wolf Motor Function Test (Morris, Uswatte, Crago, Cook, & Taub, 2001), including the Functional Ability and Performance Time scales; the Fugl-Meyer Assessment (FMA; Gladstone, Danells, & Black, 2002); and the Nine-Hole Peg Test (Chen, Chen, Hsueh, Huang, & Hsieh, 2009). Nonmotor function was assessed using the Center for Epidemiologic Studies Depression Scale (Shinar et al, 1986), the Stroke Impact Scale (SIS; Duncan et al, 1999), and the Trail Making Test Parts A and B (Tamez et al, 2011). Outcomes for cardiopulmonary function were a CPX test and the Six-Minute Walk Test (6MWT; Fulk, Echternach, Nof, & O'Sullivan, 2008).…”

Improving Quality of Life and Depression After Stroke Through Telerehabilitation

“…It also addresses overall percentage of recovery from the stroke, which is categorized as a domain in this article. The SIS has been shown to be valid and reliable in people with stroke (Duncan et al, 1999).…”

“…An emerging body of evidence has shown promising results with improved motor recovery and improvement on QOL measures with the use of robotic devices after stroke (Bovolenta, Sale, Dall'Armi, Clerici, & Franceschini, 2011;Page, Hill, & White, 2013;Posteraro et al, 2009). Page et al (2013) found that after 24 sessions with an upperextremity (UE) robot-assisted therapy device, people with chronic stroke made favorable gains in the ADL and Instrumental Activities of Daily Living (IADL), Hand Function, and Stroke Recovery domains of the Stroke Impact Scale (SIS; Duncan et al, 1999), a QOL measure used after stroke (Page et al, 2013). We previously reported significant improvements in several domains of the SIS after 30 hr of an in-clinic robot-assisted therapy intervention combined with 30 hr of repetitive task practice (Kutner et al, 2010).…”