Stroke Impact Scale: Difference between revisions

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== Objective  ==
== Objective  ==
The Stroke Impact Scale (SIS) is a [[Patient Reported Outcome Measures (PROMs)|patient-reported outcome measure]] that evaluates the biopsychosocial aspects of life after stroke. <ref>Mulder M, Nijland R. [https://pdf.sciencedirectassets.com/280397/1-s2.0-S1836955316X00021/1-s2.0-S1836955316000114/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEKH%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJIMEYCIQD1Wy%2FJcS5kR%2F%2FrQ%2FxvWVEAHcSx77TNhUgywa0eaHziyQIhAIbr71izPFzQEW%2FVOapFvLorVhWM4g3QV63UF3UIImMAKrwFCMr%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQBRoMMDU5MDAzNTQ2ODY1Igw5xdfYhR8Z5u1DeAQqkAVVb%2FlEy4bG1KL6CzwoVuqJMaV%2FcM4bWFjcpE%2BAEUexnfZclb0FI%2Bp3Cx1MnT2JxUgadmUx2Q%2BJmeGWOh4RqpMdq8VYrfm652JKX11PpzYgNlIGlYLsJPLcIce0XZlf%2BnlNB1sZAzkCmjiBWY6mCi0y0lKjUKyeHFarMPWkOhDBG2GY0KNCIH1XfB56AK1cz7F7GsZ83%2FV5EANfj442EVnZSfF7rAz6KFkN64VbYPWHcSCb0Y6lvARFraaCHMFEP3%2BCr%2FEX0QJlr%2FsDcpX3lk5HDYX596%2F0HrhLqxAU6%2FkLB7W5vStJIFUgD57BH1zkupUDw7kmS5Ob5esoKPa%2FSGszMABvDgxMDkD4hDUmekJuWY7Sy%2BuxYHhOCUZF%2FsTTkBcUuaI%2BlBTAw5cKq5g%2FcKNAt9DlN8l3mi9PAvINaVGoiPxrnnCrfcXl5joWL%2Fvu0ow3Oo%2FYbmB0Tk9jrEfgjy5PohjQy8I3maD4lXNfziMofpsymBO3Fa0gmsPPPTWPmCXT90IVPSNmBi6EEiwqEE%2BhThrBBVFIVl2RXNPn5XTOH2nHALQlRdZkhwCSGp2sJ3hB2JTEfRSRfQEqfKD2uskjeuRR0ckdTznaPd6k0WngSp8Kl6DjCsX8s9UTYsCjP0SgcAm7JRIB0lD2eWYq75hKHUIS7FAAQxEIV0fGbRGCcnEWsD8om%2BevbJYThpI4Ge8%2FW3EiIUFwsBNjkgHB6K2eiMIK%2FTHqk1gQOheD3U92%2FmW9qzD9Fa6j9VPBXgcuANwlbAl5PK9Qc2hZkjJ5LF9erZ5jlfejE%2B5PL2jRSkMWwuOYey9qvUeXssgk1gB4Op4ufUnctOkY4HwT5zbmsHikc76de3twxX06yMhkqE8JTjCUgfypBjqwAQVs1JY4XonsW0MY7qHPq2a4TJj1YDmqQvbe0hd5oR0pLxifmVVNglCx5gB%2FR5hrYx4bvwfBqoReOKNKpka0pihPajucMegSNhoByAXup9n3HYW4FeRrDv78VW%2BudlG%2FbeAxP5rQBe6cJ2EnmeYu7fnx%2Br%2BJzVKbFBsxw0uDBwU8h%2F2n6cFsr18ddLsdIoJXr8%2BFjnOpl8WVYn%2FQ9uSy%2FWMYnAMLkSZw0I7TbQltJo8s&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20231030T012125Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTK5FNNQF%2F20231030%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=aa60a5844985e6904f8bfe675a22b4561c5c8181e32223fbd5160159b18f3f2d&hash=3f333888058368e689c217daa2cea095af0ff6b34e69de02ebe0a6ec37d40cd2&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1836955316000114&tid=spdf-d5cc89b7-33b7-4b5f-a478-524871066cc4&sid=c35977968814c641ff5a1c930e4d6aa8dcb5gxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=0a0e5a5501040658535957&rr=81dfd7672eaf5de4&cc=ph Stroke impact scale.] Journal of physiotherapy. 2016;2(62):117.</ref> It is designed by Duncan et al at the University of Kansas Medical Center in 1999, first published as version 2.0.<ref>Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. [https://www.ahajournals.org/doi/epub/10.1161/01.STR.30.10.2131 The stroke impact scale version 2.0: evaluation of reliability, validity, and sensitivity to change]. Stroke. 1999 Oct;30(10):2131-40.</ref> The original 64-item tool was shortened to be 59-item after a Rasch analysis process, creating the current version 3.0.<ref>Duncan PW, Bode RK, Lai SM, Perera S, Glycine Antagonist in Neuroprotection Americas Investigators. Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Archives of physical medicine and rehabilitation. 2003 Jul 1;84(7):950-63.
The Stroke Impact Scale (SIS) is a [[Patient Reported Outcome Measures (PROMs)|patient-reported outcome measure]] that evaluates the biopsychosocial aspects of life after stroke. <ref>Mulder M, Nijland R. [https://pdf.sciencedirectassets.com/280397/1-s2.0-S1836955316X00021/1-s2.0-S1836955316000114/main.pdf?X-Amz-Security-Token=IQoJb3JpZ2luX2VjEKH%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEaCXVzLWVhc3QtMSJIMEYCIQD1Wy%2FJcS5kR%2F%2FrQ%2FxvWVEAHcSx77TNhUgywa0eaHziyQIhAIbr71izPFzQEW%2FVOapFvLorVhWM4g3QV63UF3UIImMAKrwFCMr%2F%2F%2F%2F%2F%2F%2F%2F%2F%2FwEQBRoMMDU5MDAzNTQ2ODY1Igw5xdfYhR8Z5u1DeAQqkAVVb%2FlEy4bG1KL6CzwoVuqJMaV%2FcM4bWFjcpE%2BAEUexnfZclb0FI%2Bp3Cx1MnT2JxUgadmUx2Q%2BJmeGWOh4RqpMdq8VYrfm652JKX11PpzYgNlIGlYLsJPLcIce0XZlf%2BnlNB1sZAzkCmjiBWY6mCi0y0lKjUKyeHFarMPWkOhDBG2GY0KNCIH1XfB56AK1cz7F7GsZ83%2FV5EANfj442EVnZSfF7rAz6KFkN64VbYPWHcSCb0Y6lvARFraaCHMFEP3%2BCr%2FEX0QJlr%2FsDcpX3lk5HDYX596%2F0HrhLqxAU6%2FkLB7W5vStJIFUgD57BH1zkupUDw7kmS5Ob5esoKPa%2FSGszMABvDgxMDkD4hDUmekJuWY7Sy%2BuxYHhOCUZF%2FsTTkBcUuaI%2BlBTAw5cKq5g%2FcKNAt9DlN8l3mi9PAvINaVGoiPxrnnCrfcXl5joWL%2Fvu0ow3Oo%2FYbmB0Tk9jrEfgjy5PohjQy8I3maD4lXNfziMofpsymBO3Fa0gmsPPPTWPmCXT90IVPSNmBi6EEiwqEE%2BhThrBBVFIVl2RXNPn5XTOH2nHALQlRdZkhwCSGp2sJ3hB2JTEfRSRfQEqfKD2uskjeuRR0ckdTznaPd6k0WngSp8Kl6DjCsX8s9UTYsCjP0SgcAm7JRIB0lD2eWYq75hKHUIS7FAAQxEIV0fGbRGCcnEWsD8om%2BevbJYThpI4Ge8%2FW3EiIUFwsBNjkgHB6K2eiMIK%2FTHqk1gQOheD3U92%2FmW9qzD9Fa6j9VPBXgcuANwlbAl5PK9Qc2hZkjJ5LF9erZ5jlfejE%2B5PL2jRSkMWwuOYey9qvUeXssgk1gB4Op4ufUnctOkY4HwT5zbmsHikc76de3twxX06yMhkqE8JTjCUgfypBjqwAQVs1JY4XonsW0MY7qHPq2a4TJj1YDmqQvbe0hd5oR0pLxifmVVNglCx5gB%2FR5hrYx4bvwfBqoReOKNKpka0pihPajucMegSNhoByAXup9n3HYW4FeRrDv78VW%2BudlG%2FbeAxP5rQBe6cJ2EnmeYu7fnx%2Br%2BJzVKbFBsxw0uDBwU8h%2F2n6cFsr18ddLsdIoJXr8%2BFjnOpl8WVYn%2FQ9uSy%2FWMYnAMLkSZw0I7TbQltJo8s&X-Amz-Algorithm=AWS4-HMAC-SHA256&X-Amz-Date=20231030T012125Z&X-Amz-SignedHeaders=host&X-Amz-Expires=300&X-Amz-Credential=ASIAQ3PHCVTYTK5FNNQF%2F20231030%2Fus-east-1%2Fs3%2Faws4_request&X-Amz-Signature=aa60a5844985e6904f8bfe675a22b4561c5c8181e32223fbd5160159b18f3f2d&hash=3f333888058368e689c217daa2cea095af0ff6b34e69de02ebe0a6ec37d40cd2&host=68042c943591013ac2b2430a89b270f6af2c76d8dfd086a07176afe7c76c2c61&pii=S1836955316000114&tid=spdf-d5cc89b7-33b7-4b5f-a478-524871066cc4&sid=c35977968814c641ff5a1c930e4d6aa8dcb5gxrqa&type=client&tsoh=d3d3LnNjaWVuY2VkaXJlY3QuY29t&ua=0a0e5a5501040658535957&rr=81dfd7672eaf5de4&cc=ph Stroke impact scale.] Journal of physiotherapy. 2016;2(62):117.</ref> It is designed by Duncan et al at the University of Kansas Medical Center in 1999, first published as version 2.0.<ref name=":0">Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. [https://www.ahajournals.org/doi/epub/10.1161/01.STR.30.10.2131 The stroke impact scale version 2.0: evaluation of reliability, validity, and sensitivity to change]. Stroke. 1999 Oct;30(10):2131-40.</ref> The original 64-item tool was shortened to be 59-item after a Rasch analysis process, creating the current version 3.0.<ref>Duncan PW, Bode RK, Lai SM, Perera S, Glycine Antagonist in Neuroprotection Americas Investigators. Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Archives of physical medicine and rehabilitation. 2003 Jul 1;84(7):950-63.


BibTeXEndNoteRefManRefWorks</ref>
BibTeXEndNoteRefManRefWorks</ref>
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* Memory and thinking (7 items)
* Memory and thinking (7 items)
* Participation/Role function (8 items)
* Participation/Role function (8 items)
There is an extra question




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* Formula for each scale:
* Formula for each scale:
** Transformed Scale = [(Actual raw score - lowest possible raw score) / Possible raw score range] x 100
** Transformed Scale = [(Actual raw score - lowest possible raw score) / Possible raw score range] x 100
''Note: There are three items under emotion domain (3f, 3h and 3i) that must be reverse-scored''


== Evidence  ==
== Evidence  ==
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=== Reliability  ===
=== Reliability  ===


=== Validity  ===
==== Test/Retest Reliability ====
 
* Duncan et al (1999) at 1, 3 and 6 months post-stroke findings for SIS 2.0:<ref name=":0" />
** '''Adequate to Excellent''' test-retest reliability (ICC = 0.70 to 0.92), with exception of emotion domain having moderate reliability (ICC=0.57).<ref name=":0" />
* Edwards and O'connell (2003) supports the findings of Duncan et al for SIS 2.o and SIS-16:<ref>Edwards B, O'connell B. Internal consistency and validity of the Stroke Impact Scale 2.0 (SIS 2.0) and SIS-16 in an Australian sample. Quality of Life Research. 2003 Dec;12:1127-35.</ref>
** '''Adequate to Excellent'''  test-retest reliability in all domains except for the emotion domain that showed '''Poor''' test-retest reliability.
* Vellone et al (2015) findings for SIS 3.0:<ref name=":1">Vellone E, Savini S, Fida R, Dickson VV, Melkus GD, Carod-Artal FJ, Rocco G, Alvaro R. Psychometric evaluation of the stroke impact scale 3.0. Journal of Cardiovascular Nursing. 2015 May 1;30(3):229-41.</ref>
** '''Good''' test-retest reliability (ICC .79 for global stroke recovery and .98 for cognitive factor).
 
==== Interrater/Intrarater Reliability ====
 
* Carod-Artal et al (2009) for SIS 3.o:<ref name=":2">Carod-Artal FJ, Coral LF, Trizotto DS, Moreira CM. [https://www.ahajournals.org/doi/10.1161/STROKEAHA.109.558031?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Self-and proxy-report agreement on the Stroke Impact Scale.] Stroke. 2009 Oct 1;40(10):3308-14.</ref>
** '''Excellent''' interrater reliability for hand function (ICC = 0.82) and mobility (ICC = 0.80) domains
** '''Adequate''' interrater reliability for strength (ICC = 0.61), ADL/IADL (ICC = 0.74), and memory and thinking (ICC = 0.43) domains
** '''Poor''' interrater reliability for communication (ICC = 0.39), emotion (ICC = 0.17), and social participation (ICC = 0.29) domains
 
==== Internal Consistency ====
 
* Duncan et al (1999) SIS version 2.0, Acute Stroke:<ref name=":0" />
** '''Excellent:''' Cronbach's alpha range in all 8 domains: 0.83 to 0.90
 
* Carod-Artal et al (2009) Chronic Stroke:<ref name=":2" />
** '''Excellent''' internal consistency for 7 domains:
*** Strength (ICC = 0.82)
*** Hand function (ICC = 0.95)
*** Mobility (ICC = 0.94)
*** ADL/IADL (ICC = 0.87)
*** Memory (ICC = 0.92)
*** Communcation (ICC = 0.84)
*** Social participation (ICC = 0.85)
** '''Adequate''' interrater reliability for emotion domain (ICC = 0.49)
 
* Vellone et al (2015), Chronic Stroke:<ref name=":1" />
** '''Excellent''' internal consistency ranging from 0.89 to 0.98.
 
* Richardson et al (2016), Subacute Stroke:<ref>Richardson M, Campbell N, Allen L, Meyer M, Teasell R. The stroke impact scale: performance as a quality of life measure in a community-based stroke rehabilitation setting. Disability and rehabilitation. 2016 Jul 2;38(14):1425-30.</ref>
** '''Excellent''' internal consistency at all timepoints
*** Cronbach’s alpha > 0.81.
*** Composite Physical Functioning score was excellent at all timepoints (Cronbach’s alpha > 0.95)
 
* MacIsaac et al (2016), Acute Stroke:<ref>MacIsaac R, Ali M, Peters M, English C, Rodgers H, Jenkinson C, Lees KR, Quinn TJ, VISTA Collaboration. [https://www.ahajournals.org/doi/full/10.1161/JAHA.115.003108?rfr_dat=cr_pub++0pubmed&url_ver=Z39.88-2003&rfr_id=ori%3Arid%3Acrossref.org# Derivation and validation of a modified short form of the stroke impact scale.] Journal of the American Heart Association. 2016 May 20;5(5):e003108.</ref>
** '''Excellent''' internal consistency (Cronbach’s alpha > .93).


=== Responsiveness  ===
=== Responsiveness  ===

Revision as of 16:11, 4 November 2023

This article or area is currently under construction and may only be partially complete. Please come back soon to see the finished work! (4/11/2023)

Original Editor - Carina Therese Magtibay

Top Contributors - Carina Therese Magtibay  

Objective[edit | edit source]

The Stroke Impact Scale (SIS) is a patient-reported outcome measure that evaluates the biopsychosocial aspects of life after stroke. [1] It is designed by Duncan et al at the University of Kansas Medical Center in 1999, first published as version 2.0.[2] The original 64-item tool was shortened to be 59-item after a Rasch analysis process, creating the current version 3.0.[3]

For patients who are unable to answer, there is a proxy version available called Stroke Impact Scale-16.[4]

Intended Population[edit | edit source]

The tool is intended for post-stroke patients, administered repeatedly over time to track changes.

Method of Use[edit | edit source]

Equipment required: Questionnaire and pen

Time to administer: 15-20 minutes

Instructions: Rate the level of difficulty of completing an item in the past 2 weeks following a 5-point Likert scale:

  • 1 = could not do it at all
  • 2= very difficult
  • 3= somewhat difficult
  • 4= a little difficult
  • 5= not difficult at all


Domains:

The questionnaire consists of 59 items that assess 8 domains:

  • Strength (4 items)
  • Hand function (5 items)
  • ADL/IADL (10 items)
  • Mobility (9 items)
  • Communication (7 items)
  • Emotion (9 items)
  • Memory and thinking (7 items)
  • Participation/Role function (8 items)

There is an extra question


Scoring:

  • Summative scores are generated for each domain, scores ranging from 0-100.
  • Formula for each scale:
    • Transformed Scale = [(Actual raw score - lowest possible raw score) / Possible raw score range] x 100


Note: There are three items under emotion domain (3f, 3h and 3i) that must be reverse-scored

Evidence[edit | edit source]

Reliability[edit | edit source]

Test/Retest Reliability[edit | edit source]

  • Duncan et al (1999) at 1, 3 and 6 months post-stroke findings for SIS 2.0:[2]
    • Adequate to Excellent test-retest reliability (ICC = 0.70 to 0.92), with exception of emotion domain having moderate reliability (ICC=0.57).[2]
  • Edwards and O'connell (2003) supports the findings of Duncan et al for SIS 2.o and SIS-16:[5]
    • Adequate to Excellent  test-retest reliability in all domains except for the emotion domain that showed Poor test-retest reliability.
  • Vellone et al (2015) findings for SIS 3.0:[6]
    • Good test-retest reliability (ICC .79 for global stroke recovery and .98 for cognitive factor).

Interrater/Intrarater Reliability[edit | edit source]

  • Carod-Artal et al (2009) for SIS 3.o:[7]
    • Excellent interrater reliability for hand function (ICC = 0.82) and mobility (ICC = 0.80) domains
    • Adequate interrater reliability for strength (ICC = 0.61), ADL/IADL (ICC = 0.74), and memory and thinking (ICC = 0.43) domains
    • Poor interrater reliability for communication (ICC = 0.39), emotion (ICC = 0.17), and social participation (ICC = 0.29) domains

Internal Consistency[edit | edit source]

  • Duncan et al (1999) SIS version 2.0, Acute Stroke:[2]
    • Excellent: Cronbach's alpha range in all 8 domains: 0.83 to 0.90
  • Carod-Artal et al (2009) Chronic Stroke:[7]
    • Excellent internal consistency for 7 domains:
      • Strength (ICC = 0.82)
      • Hand function (ICC = 0.95)
      • Mobility (ICC = 0.94)
      • ADL/IADL (ICC = 0.87)
      • Memory (ICC = 0.92)
      • Communcation (ICC = 0.84)
      • Social participation (ICC = 0.85)
    • Adequate interrater reliability for emotion domain (ICC = 0.49)
  • Vellone et al (2015), Chronic Stroke:[6]
    • Excellent internal consistency ranging from 0.89 to 0.98.
  • Richardson et al (2016), Subacute Stroke:[8]
    • Excellent internal consistency at all timepoints
      • Cronbach’s alpha > 0.81.
      • Composite Physical Functioning score was excellent at all timepoints (Cronbach’s alpha > 0.95)
  • MacIsaac et al (2016), Acute Stroke:[9]
    • Excellent internal consistency (Cronbach’s alpha > .93).

Responsiveness[edit | edit source]

Miscellaneous
[edit | edit source]

Links[edit | edit source]

Stroke Impact Scale version 3.0

Stroke Impact Scale-16

References[edit | edit source]

  1. ↑ Mulder M, Nijland R. Stroke impact scale. Journal of physiotherapy. 2016;2(62):117.
  2. ↑ 2.0 2.1 2.2 2.3 Duncan PW, Wallace D, Lai SM, Johnson D, Embretson S, Laster LJ. The stroke impact scale version 2.0: evaluation of reliability, validity, and sensitivity to change. Stroke. 1999 Oct;30(10):2131-40.
  3. ↑ Duncan PW, Bode RK, Lai SM, Perera S, Glycine Antagonist in Neuroprotection Americas Investigators. Rasch analysis of a new stroke-specific outcome scale: the Stroke Impact Scale. Archives of physical medicine and rehabilitation. 2003 Jul 1;84(7):950-63. BibTeXEndNoteRefManRefWorks
  4. ↑ Duncan PW, Lai SM, Tyler D, Perera S, Reker DM, Studenski S. Evaluation of proxy responses to the Stroke Impact Scale. Stroke. 2002 Nov 1;33(11):2593-9.
  5. ↑ Edwards B, O'connell B. Internal consistency and validity of the Stroke Impact Scale 2.0 (SIS 2.0) and SIS-16 in an Australian sample. Quality of Life Research. 2003 Dec;12:1127-35.
  6. ↑ 6.0 6.1 Vellone E, Savini S, Fida R, Dickson VV, Melkus GD, Carod-Artal FJ, Rocco G, Alvaro R. Psychometric evaluation of the stroke impact scale 3.0. Journal of Cardiovascular Nursing. 2015 May 1;30(3):229-41.
  7. ↑ 7.0 7.1 Carod-Artal FJ, Coral LF, Trizotto DS, Moreira CM. Self-and proxy-report agreement on the Stroke Impact Scale. Stroke. 2009 Oct 1;40(10):3308-14.
  8. ↑ Richardson M, Campbell N, Allen L, Meyer M, Teasell R. The stroke impact scale: performance as a quality of life measure in a community-based stroke rehabilitation setting. Disability and rehabilitation. 2016 Jul 2;38(14):1425-30.
  9. ↑ MacIsaac R, Ali M, Peters M, English C, Rodgers H, Jenkinson C, Lees KR, Quinn TJ, VISTA Collaboration. Derivation and validation of a modified short form of the stroke impact scale. Journal of the American Heart Association. 2016 May 20;5(5):e003108.
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