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Stroke Impact Scale-16: A brief assessment of physical function
P W Duncan1, S M Lai, R K Bode
1Brooks Center for Rehabilitation Studies, University of Florida, North Florida/South Georgia Department of Veteran Affairs, Gainesville, FL, USA. pwduncan@hp.ufl.edu
Neurology
|January 29, 2003
Summary
The new Stroke Impact Scale-16 (SIS-16) effectively assesses physical function in stroke survivors, outperforming the Barthel Index (BI) in differentiating disability levels due to reduced ceiling effects.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biostatistics
Background:
- Stroke significantly impacts physical function, necessitating reliable assessment tools.
- Existing measures like the Barthel Index (BI) may have limitations in detecting subtle functional changes.
- The Stroke Impact Scale (SIS) is a comprehensive tool, but a shorter version is needed for early post-stroke assessment.
Purpose of the Study:
- To develop and validate the Stroke Impact Scale-16 (SIS-16), a brief instrument for assessing physical function 1-3 months post-stroke.
- To compare the discriminative ability of the SIS-16 against the Barthel Index (BI).
Main Methods:
- Rasch analysis was used to select 12 items from the SIS 3.0 physical domain to create the SIS-16.
- 621 stroke patients from the GAIN Americas trial were included.
- Statistical analyses, including ANOVA, compared SIS-16 and BI performance across modified Rankin Scale categories.
Main Results:
- The SIS-16 was developed with minimal loss of reliability.
- The SIS-16 demonstrated less pronounced ceiling effects than the BI, enabling better differentiation of less severe limitations.
- SIS-16 scores significantly differed across more Rankin levels (0-5) compared to the BI (0-2, 3-5).
Conclusions:
- The SIS-16 is a validated, short instrument for assessing a broad range of physical function in early post-stroke patients.
- The SIS-16 offers superior discrimination of disability levels compared to the BI, particularly for milder impairments.