| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From Brooks Center for Rehabilitation Studies, University of Florida, and Rehabilitation Outcomes Research Center (Dr. Duncan), North Florida/South Georgia Department of Veteran Affairs, Gainesville, FL; Department of Preventive Medicine and Center on Aging (Drs. Lai and Perera), University of Kansas Medical Center, Kansas City; Rehabilitation Services Evaluation Unit, Rehabilitation Institute of Chicago, and Department of Physical Medicine & Rehabilitation (Dr. Bode), Northwestern University Medical School, Chicago; and Department of Neurology (J. DeRosa), Columbia University–New York Presbyterian Medical Center, New York, NY.
Address correspondence and reprint requests to Dr. Pamela W. Duncan, Brooks Center for Rehabilitation Studies, College of Health Professions, University of Florida, Health Science Center, Box 100185, Gainesville, FL 32610-0185; e-mail: pwduncan{at}hp.ufl.edu
Objectives: To 1) develop a short instrument (Stroke Impact Scale–16 [SIS-16]) to assess physical function in patients with stroke at approximately 1 to 3 months poststroke using items from the composite physical domain of the Stroke Impact Scale (SIS) version 3.0, and 2) compare the SIS-16 and a commonly used disability measure, the Barthel Index (BI), in terms of their ability to discriminate disability.
Methods: A total of 621 subjects enrolled in the GAIN Americas randomized stroke trial were included in this study. Rasch analysis, which models the probability of a subject’s response to an item using both subject ability and item difficulty, was used to construct the SIS-16, describe its properties, and compare its ordering and range of item difficulties to those of the BI. Box plots and analysis of variance were used to examine differences in BI and SIS-16 scores across modified Rankin categories.
Results: The study sample had an average age of 68 ± 12.4 years and 56% were men. Stroke diagnoses were classified as minor in 91 patients (NIH Stroke Scale score [NIHSS] 0 to 5), moderate in 304 (NIHSS 6 to 13), and major in 226 (NIHSS 
14). Twelve of the original 28 items in the SIS version 3.0 composite physical domain were eliminated to produce the SIS-16, with a minimal loss of reliability. As compared to the BI, the SIS-16 contains more difficult items that can differentiate patients with less severe limitations, and therefore has less pronounced ceiling effects. SIS-16 scores were significantly different across Rankin levels 0 to 1, 2, 3, 4, and 5, whereas BI was significantly different only across Rankin levels 0 to 2, 3, 4, and 5.
Conclusion: Compared to the BI, the SIS-16 is an excellent collection of items suitable for assessing a wide range of physical function limitations of patients with stroke at 1 to 3 months poststroke. Because of a less pronounced ceiling effect, the SIS-16 can differentiate lower levels of disability as compared to the BI.
This article has been cited by other articles:
|
|
 |
|
  F. J. Carod-Artal, L. F. Coral, D. S. Trizotto, and C. M. Moreira The Stroke Impact Scale 3.0: Evaluation of Acceptability, Reliability, and Validity of the Brazilian Version Stroke, September 1, 2008; 39(9): 2477 - 2484. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. D. Lyden, A. Shuaib, K. R. Lees, A. Davalos, S. M. Davis, H.-C. Diener, J. C. Grotta, T. J. Ashwood, H.-G. Hardemark, H. H. Svensson, et al. Safety and Tolerability of NXY-059 for Acute Intracerebral Hemorrhage: The CHANT Trial Stroke, August 1, 2007; 38(8): 2262 - 2269. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Schmid, P. W. Duncan, S. Studenski, S. M. Lai, L. Richards, S. Perera, and S. S. Wu Improvements in Speed-Based Gait Classifications Are Meaningful Stroke, July 1, 2007; 38(7): 2096 - 2100. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Banks and C. A. Marotta Outcomes Validity and Reliability of the Modified Rankin Scale: Implications for Stroke Clinical Trials: A Literature Review and Synthesis Stroke, March 1, 2007; 38(3): 1091 - 1096. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Xie, E. Q. Wu, Z.-J. Zheng, J. B. Croft, K. J. Greenlund, G. A. Mensah, and D. R. Labarthe Impact of Stroke on Health-Related Quality of Life in the Noninstitutionalized Population in the United States Stroke, October 1, 2006; 37(10): 2567 - 2572. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Kissela The Value of Quality of Life Research in Stroke Stroke, August 1, 2006; 37(8): 1958 - 1959. [Full Text] [PDF]
|
|
|
|
|
|
P. W. Duncan, R. Zorowitz, B. Bates, J. Y. Choi, J. J. Glasberg, G. D. Graham, R. C. Katz, K. Lamberty, and D. Reker Management of Adult Stroke Rehabilitation Care: A Clinical Practice Guideline Stroke, September 1, 2005; 36(9): e100 - e143. [Full Text] [PDF]
|
|
|
|
|
|
M. Fisher and for the Stroke Therapy Academic Industry Roundtabl Enhancing the Development and Approval of Acute Stroke Therapies: Stroke Therapy Academic Industry Roundtable Stroke, August 1, 2005; 36(8): 1808 - 1813. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. K. Kapral, J. Fang, M. D. Hill, F. Silver, J. Richards, C. Jaigobin, A. M. Cheung, and for the Investigators of the Registry of the Canad Sex Differences in Stroke Care and Outcomes: Results From the Registry of the Canadian Stroke Network Stroke, April 1, 2005; 36(4): 809 - 814. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I-P. Hsueh, W.-C. Wang, C.-F. Sheu, and C.-L. Hsieh Rasch Analysis of Combining Two Indices to Assess Comprehensive ADL Function in Stroke Patients Stroke, March 1, 2004; 35(3): 721 - 726. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S.-M. Lai, S. Perera, P. W. Duncan, and R. Bode Physical and Social Functioning After Stroke: Comparison of the Stroke Impact Scale and Short Form-36 Stroke, February 1, 2003; 34(2): 488 - 493. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
