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RehabMeasures Instrument

Stroke-Adapted Sickness Impact Profile

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The SA-SIP-30 assesses perceived health status following stroke.

Link to Instrument

Instrument Details

Acronym SA-SIP-30

Area of Assessment

Activities of Daily Living
Functional Mobility
General Health
Life Participation
Quality of Life
Social Relationships

Assessment Type

Patient Reported Outcomes

Administration Mode

Paper & Pencil




  • Stroke Recovery


Key Descriptions

  • Each of the 30 items is a statement describing a change in behavior that reflects the impact of illness on some aspect of daily life.
  • Patients are asked to mark items most descriptive of themselves on a given day. All responses are "yes" or "no."
  • Scale items are weighted to reflect the relative importance of the item to health status.
  • 8 subscales:
    1) Body Care and Movement
    2) Social Interaction
    3) Mobility
    4) Communication
    5) Emotional Behavior
    6) Household Management
    7) Alertness Behavior
    8) Ambulation
  • Subscales can be combined to form 2 dimensions:
    1) Physical
    2) Psychosocial
  • To score the scale, weights are applied to marked items, summed for each subscale and expressed as a percentage for each subscale ranging from 0 to 100%.
  • Higher scores indicate a less desirable health outcome.
  • The SA-SIP-30 can be administered to either a patient or by an interviewer.
  • In the literature, SA-SIP-30 is addressed as a health-related quality of life measure, but health status may be more appropriate (Verhoeven et al., 2011).

Number of Items


Time to Administer

30 minutes

Required Training

No Training

Age Ranges


18 - 64


Elderly Adult

65 +


Instrument Reviewers

Originally reviewed by Jane Sullivan PT, DHS and the StrokEDGE group of the Neurology Section of the American Physical Therapy Association; Updated by University of Illinois at Chicago Master of Science in Occupational Therapy students Alexa Adducci, Julia Ramirez, and Janelle Washko

ICF Domain

Body Function

Measurement Domain

General Health

Professional Association Recommendation

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (Vestibular EDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

For detailed information about how recommendations were made, please visit:




Highly Recommend




Reasonable to use, but limited study in target group  / Unable to Recommend


Not Recommended

Recommendations for use based on acuity level of the patient:



(CVA < 2 months post)

(SCI < 1 month post) 

(Vestibular < 6 weeks post)


(CVA 2 to 6 months)

(SCI 3 to 6 months)


(> 6 months)





Recommendations based on level of care in which the assessment is taken:


Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility



Home Health







Recommendations for entry-level physical therapy education and use in research:


Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)





Not reported


  • Not Suitable for Use With Proxies (e.g. caregivers).


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Cut-Off Scores

Chronic Stroke: (van Straten et al., 2000; n = 407; mean = 70 (13) years; assessment at 6 months post stoke; Dutch sample)

  • >33 Total or >40 Physical Dimension indicates impairment in ADLs, inability to live independently, difficulty with self-care, and difficulty with mobility and performing their main activity.

Normative Data

Chronic Stroke(Taken from van Straten et al., 2000)

SIP Scores That Correspond to a Poor Health Outcome:




Poor Outcomes

Total Score

Physical Dimension

Bethel Index



>28 (77%)

>40 (84%)

Rankin Score

Global Functioning


>25 (84%

>20 (85%)




>33 (80%)

>40 (79%)

Euroqul Mobility



>26 (77%)

>40 (86%)

Euroqul Self-care



>24 (75%)

>40 (84%)

HRQL = Health Related Quality of Life; () = Percentage of patients correctly classified. Percentages  < 75% not shown; psychosocial dimension not shown because the percentage of patients correctly classified was < 75% on all ICIDH and HRQL measures

Internal Consistency

Chronic Stroke: (van Straten et al, 1997; n = 319; assessed 6 months post stroke; Dutch sample)

  • Good to Excellent internal consistency

    • Total SA-SIP30, Cronbach's alpha = 0.85

    • Psychosocial Dimension, Cronbach's alpha = 0.78

    • Physical Dimension, Cronbach's alpha = 0.82

Chronic Stroke: (van de Port et al., 2004; n = 122; mean = 57 (12) years; assessed at 6 months and 1 year post stroke; Mean Barthel Index at inclusion = 12.7 (4.5); Dutch sample)

  • Good to Excellent internal consistency

    • Total SA-SIP30, Cronbach's alpha = 0.82

    • Physical Dimension, Cronbach's alpha = 0.76

  • Poor internal consistency

    • Psychosocial Dimension, Cronbach's alpha = 0.68

Acute Stroke: (Allen et al., 2002; n = 96; intervention group mean age = 69 (1.7) years, usual care group mean age = 72 (1.5) years; assessed 48 hours prior to discharge from acute stroke unit)

  • Excellent internal consistency with removal of activities of daily living questions, Cronbach’s alpha = 0.83

Construct Validity

Chronic Stroke: (van de Port et al., 2004)






The Sickness Impact Profile (SIP) total

29.3 (13.7)

29.5 (17.2)



Physical dimension

26.7 (15.6)

35.9 (23.4)*



Psychosocial dimension

25.1 (17.2)

22.9 (17.5)*



Mean scores (Standard Deviations) and Pearson correlation coefficients (r); *t-test, p < 0.05; 
**p < 0.01; Van Straten et al. (1997) created the Sickness Impact Profile (SA-SIP30) from the original SIP136


Convergent Validity:


Mild Stroke: (Edwards et al., 2006; n = 219; mean age = 64.74 (15.87) years; 6 months post-stroke)

  • SA-SIP30 is a strong predictor of Reintegration to Normal Living (RNL) scores assessing life satisfaction

Severe Stroke: (Salter et al., 2005 – critical review)

  • The SIP-136 and SA-SIP-30 scale were shown to have lower levels of agreement when utilized with patients who have experienced a severe stroke. The SA-SIP30 does not assess pain, recreation, energy, general health perceptions, overall quality of life, or stroke symptoms.


Discriminant Validity:

Chronic Stroke: (Cup et al., 2003; n = 26; n = 24, six months post stroke onset; n = 2, two months post stroke onset; mean age = 68 (15) years)

  • Poor correlations between the Canadian Occupational Performance Measure and SA-SIP30 (r = 0.102)

First-time chronic stroke: (Verhoeven et al., 2011; n = 209; mean age = 56.5 (11.3) years; one year and three years post-stroke)

  • At one year post stroke, the Cambridge Cognitive Examination (CAMCOG) Orientation was a significant determinant of the SA-SIP-30 Psychosocial dimension, whereas CAMCOG Memory was a significant predictor of the SA-SIP-30 Physical dimension and CAMCOG Perception was a predictor of SA-SIP-30 Total score.

  • At three years post-stroke, CAMCOG Perception was a significant determinant of SA-SIP-30 Total score and Physical dimension. CAMGOG Language was the only predictor of the SA-SIP-30 Psychosocial dimension.

  • CAMCOG scores together explained 6.5% of the variance of the SA-SIP-30 Total score, 10.9% of the variance of the SA-SIP-30 Physical dimension, and 1.7% of the variance of the SA-SIP-30 Psychosocial dimension.

First-ever Supratentorial Stroke: (Schepers et al., 2006; n = 163; mean age = 56 (11) years; 6 and 12 months post-stroke)

  • Comparison of the Barthel Index (BI), Functional Independence Measure (FIM), Frenchay Activities Index (FAI) and SA-SIP30:

    • Subacute phase (0-6 months post-stroke): recommended use of BI

    • Chronic phase (6-12 months post-stroke): the FAI and SA-SIP30 detected the most changes and had moderate effect sizes. Recommend use of the FAI and SA-SIP30 for chronic phase, especially for the stroke rehabilitation population

  • FAI and SA-SIP30 focus more on instrumental ADL and social functioning - expected to show larger effect sizes in the chronic phase than the BI and FIM.

Stroke—Chronic Phase: (Schepers et al., 2006; n = 163; mean age = 56 (11) years; 6 and 12 months post-stroke)

  • Because of its focus on IADLs and social functioning, larger effect sizes were shown in the chronic phase compared to the FIM and Barthel Index.

Poststroke Spasticity in the UE: (Doan et al., 2012; n = 279; mean age = 52.8 (NR) years)

  • Greater disability scores in all problem domains on the Disability Assessment Scale were significantly associated with higher overall dysfunction scores on the SA-SIP30.

Content Validity

  • Linear regression was used to assess the relevance of the 136 items with a forward selection strategy, using the F statistic with p = 0.5 as the criteria level for selection. 

  • Item selection for each subscale was completed when the items in the regression model explained 80% of the variance in score of the original total subscale.

  • Items listed within some of the subscales could potentially be included in other subscales (i.e., ‘Stay home most of the time’ and ‘not going into town’ is under mobility but could also be listed under social interaction) (Salter et al., 2008)


Chronic Stroke(van de Port et al., 2004)

  • Moderate Responsiveness; effect sizes (6 months to one year post-stroke):

    • Total SA-SIP-30 = 0.60

    • Physical Dimension = 0.56

    • Psychosocial Dimension = 0.65 


Allen, K. R., Hazelett, S., Jarjoura, D., Wickstrom, G. C., Hua, K., Weinhardt, J., & Wright, K. (2002). Effectiveness of a postdischarge care management model for stroke and transient ischemic attack: A randomized trial. Journal of Stroke and Cerebrovascular Disease, 11(2), 88-98. Find it on PubMed

Cup, E. H., Scholte op Reimer, W. J., Thijssen, M. C., & van Kuyk-Minis, M. A. (2003). Reliability and validity of the Canadian Occupational Performance Measure in stroke patients. Clinical Rehabilitation 17(4): 402-409. Find it on PubMed

Desrosiers, J., Noreau, L., Rochette, A., Carbonneau, H., Fontaine, L., Viscogliosi, C., Bravo, G. (2007). Effect of a home leisure education program after stroke: A randomized controlled trial. Archives of Physical Medicine and Rehabilitation, 88(9), 1095-1100. Find it on PubMed

Doan, Q. V., Brashear, A., Gillard, P. J., Varon, S. F., Vandenburgh, A. M., Turkel, C. C., & Elovic, E. P. (2012). Relationship between disability and health-related quality of life and caregiver burden in patients with upper limb poststroke spasticity. American Academy of Physical Medicine and Rehabilitation, 4, 4-10. Find it on PubMed

Edwards, D. F., Hahn, M., Baum, C., & Dromerick, A. W. (2006). The impact of mild stroke on meaningful activity and life satisfaction. Journal of Stroke and Cerebrovascular Diseases, 15(4), 151-157. Find it on PubMed

Salter, K., Jutai, J. W., Teasell, R., Foley, N. C., Bltensky, J., & Bayley, M. (2005). Issue for selection of outcome measures in stroke rehabilitation: ICF participation. Disability and Rehabilitation, 27(9), 507-528. Find it on PubMed

Salter, K.L., Moses, M.B., Foley, N.C., & Teasell, R.W. (2008). Health-related quality of life after stroke: What are we measuring? International Journal of Rehabilitation Research, 31(2),111-7. Find it on PubMed

Schepers, V. P. M., Ketelaar, M., van de Port I. G., Visser-Meily, J. M., & Lindeman, E. (2007). Comparing contents of functional outcome measures in stroke rehabilitation using the International Classification of Functioning, Disability and Health. Disability and Rehabilitation, 29(3), 221-230. Find it on PubMed

Schepers, V. P. M., Ketelaar, M., Visser-Meily, J. M., Dekker, J., & Lindeman, E. (2006). Responsiveness of functional health status measures frequently used in stroke research. Disability and Rehabilitation, 28(17), 1035-1040. Find it on PubMed

Van de Port, I. G., Ketelaar, M., Schepers, V. P., Van den Bos, G. A., & Lindeman, E. (2004). Monitoring the functional health status of stroke patients: tThe value of the Stroke-Adapted Sickness Impact Profile-30. Disability and Rehabilitation, 26(11), 635-640. Find it on PubMed

van Straten, A., de Haan, R. J., Limburg, M., Schuling, J., Bossuyt, P. M., van den Bos, G. A. (1997). A stroke-adapted 30-item version of the Sickness Impact Profile to assess quality of life (SA-SIP30). Stroke, 28(11), 2155-2161. Find it on PubMed

van Straten, A., de Haan, R. J., Limburg, M., van den Bos, G. A. (2000). Clinical meaning of the Stroke-Adapted Sickness Impact Profile-30 and the Sickness Impact Profile-136. Stroke, 31(11), 2610-2615. Find it on PubMed

Verhoeven, C. L., Schepers, V. P., Post, M. W., van Heugten, C. M. (2011). The predictive value of cognitive impairments measured at the start of clinical rehabilitation for health status 1 year and 3 years poststroke. International Journal of Rehabilitation Research, 34(1), 38-43. Find it on PubMed