Stroke-Adapted Sickness Impact Profile

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.

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

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

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

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

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.

• 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