Stroke Impact Scale

Assessment Overview

Purpose: Examine and quantify the recovery of patients with post-stroke hemiplegia in both clinic and research settings

Summary: There are 59 items encompassed in 8 domains of the test including strength, hand function, ADL/IADL, mobility, communication, emotion, memory and thinking, and participation/role function. The patient ranks each item on a 5 point scale and the score is calculated using a formula with free scoring software available.

Equipment: Questionnaire and pencil

ICF Category: Activity, participation.

Assessment Handout

Stroke Impact Scale (2).doc

Assessment Psychometrics

The FMA is highly recommended for use in those with subacute, or chronic strokes and is highly recommended for use in skilled nursing facilities, outpatient rehabilitation, and home health. This measure should be taught to students and is appropriate for use in research. The psychometrics are reported below:

SEM: Strength: 8.7, ADL/IADL: 6.3, Mobility: 5.5, Hand function: 9.4
MDC: Strength: 24.0, ADL/IADL: 17.3, Mobility: 15.1, Hand function: 25.9
MCID: Strength: 9.2, ADL/IADL: 5.9, Mobility: 4.5, Hand function: 17.8
Normative Data Mean: Strength: 40.73, Memory: 81.54, Emotion: 59.63, Communication: 89.71, ADL/IADL: 67.41, Mobility: 79.25, Hand function: 29.63 , Social participation: 47.92
Test/Retest Reliability: Good (ICC =0.79 for global stroke recovery)
Interrater/Intrarater Reliability: Excellent for hand function (ICC=0.82) and mobility (ICC=0.80), Adequate for strength (ICC=0.61), ADL/IADL (ICC=0.74), and memory and thinking (ICC=0.43), Poor for communication (ICC=0.39), emotion (ICC=0.17), and social participation (ICC=0.29)
Internal Consistency: Excellent for chronic stroke for the emotional factor (0.89) and physical factor (0.98). Excellent for subacute stroke (Cronbach's alpha > 0.95). Excellent for acute stroke (Cronbach's alpha > 0.93)
Criterion Validity: Excellent correlation between FIM-motor and SIS-ADL (r=0.86). Excellent correlation between SF-36V and SIS-physical (r=0.77). Initial FIM score predicted overall ADL/IADL subscale scores
Concurrent Validity: Chronic: Excellent correlation with Mini-Mental Status Exam (r=0.69), Barthel Index (r=0.69), and HADS-Anxiety (r=0.68) and HADS-Depression (r=0.67); Subacute: Excellent correlation with 5-level EuroQoL at admission, 6 month, and 12 month follow-up (r=0.618-0.760)
Construct Validity: Excellent correlation with Burden of Stroke Scale (r=-0.83)
Content Validity: Tool developed from study using interviews from patients, caregivers, and healthcare professionals
Floor/Ceiling Effects: Poor ceiling effects in hand function delay at baseline, 6 months, 12 months; memory and thinking at 6 months and 12 months; mobility at 6 months, ADL/IADL at 12 months. No significant floor effects

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