Derivation and Validation of a Modified Short Form of the Stroke Impact Scale

MacIsaac, Rachael; Ali, Myzoon; Peters, Michele; English, Coralie; Rodgers, Helen; Jenkinson, Crispin; Lees, Kennedy R.; Quinn, Terence J

doi:10.1161/jaha.115.003108

Cited by 26 publications

(30 citation statements)

References 22 publications

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“…There is a tension between having a tool that allows comprehensive assessment and having a tool that does not require a lengthy and burdensome interview. In this regard, recent attempts to create shorter HR-QOL forms that retain the most discriminating questions are welcome ( 43 ).…”

Section: Quality Of Lifementioning

confidence: 99%

Functional Assessment for Acute Stroke Trials: Properties, Analysis, and Application

et al. 2018

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A measure of treatment effect is needed to assess the utility of any novel intervention in acute stroke. For a potentially disabling condition such as stroke, outcomes of interest should include some measure of functional recovery. There are many functional outcome assessments that can be used after stroke. In this narrative review, we discuss exemplars of assessments that describe impairment, activity, participation, and quality of life. We will consider the psychometric properties of assessment scales in the context of stroke trials, focusing on validity, reliability, responsiveness, and feasibility. We will consider approaches to the analysis of functional outcome measures, including novel statistical approaches. Finally, we will discuss how advances in audiovisual and information technology could further improve outcome assessment in trials.

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Section: Quality Of Lifementioning

confidence: 99%

Functional Assessment for Acute Stroke Trials: Properties, Analysis, and Application

et al. 2018

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“…These data have been used to investigate novel hypotheses including analyses of stroke assessment scale properties. 16,17 We selected all patient-level data that contained BI along with any other functional outcome measure. Within VISTA we had access to datasets from acute stroke settings and rehabilitation studies.…”

Section: Validation Of Short Form Barthel Indexmentioning

confidence: 99%

Use of a 3-Item Short-Form Version of the Barthel Index for Use in Stroke

MacIsaac

Ali

Taylor‐Rowan

et al. 2017

Stroke

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T he Barthel Index (BI) is a 10-item measure of basic activities of daily living (ADL). 1 The BI is the second most commonly used functional assessment scale in stroke trials and the most commonly used ADL assessment in adult rehabilitation.2,3 BI quantifies ADL in an ordinal, hierarchical scale that ranges from 0 to 20 or 0 to 100 depending on the scoring used. 4 BI is recommended as an outcome measure by various professional societies and guidelines.3 BI has proven prognostic utility, 5 it is used in clinical practice to inform rehabilitation and care planning, and it is used in research both to describe outcomes and as case-mix adjuster. The BI has proven a useful scale, but there is scope for improvement, for example, floor and ceiling effects of BI scoring are well described. 6 For any assessment, there is a trade-off between the time and effort required for testing and the validity of the data acquired. 7 Although administration time for BI assessment is modest, there is still opportunity cost, particularly in busy clinical settings. 8 Issues with time taken to complete a scale are important to the assessor (longer time spent in assessment gives less time for other clinical activity) and are important to the patient (test burden is a particular issue in the context of acute stroke). These issues will be more apparent in patients with physical, cognitive, or communication difficulties, yet this is exactly the population that requires robust assessment of function. In the National Health Service (NHS) England and Wales National Stroke Audit, completion rate of BI measures was ≈60%, with lack of time cited as the reason forBackground and Purpose-There may be a potential to reduce the number of items assessed in the Barthel Index (BI), and shortened versions of the BI have been described. We sought to collate all existing short-form BI (SF-BI) and perform a comparative validation using clinical trial data. Methods-We performed a systematic review across multidisciplinary electronic databases to find all published SF-BI.Our validation used the VISTA (Virtual International Stroke Trials Archive) resource. We describe concurrent validity (agreement of each SF-BI with BI), convergent and divergent validity (agreement of each SF-BI with other outcome measures available in the data set), predictive validity (association of prognostic factors with SF-BI outcomes), and content validity (item correlation and exploratory factor analyses). Results-From 3546 titles, we found 8 articles describing 6 differing SF-BI. Using acute trial data (n=8852), internal reliability suggested redundancy in BI (Cronbach α, 0.96). Each SF-BI demonstrated a strong correlation with BI, modified Rankin Scale, National Institutes of Health Stroke Scale (all ρ≥0.83; P<0.001). Using rehabilitation trial data (n=332), SF-BI demonstrated modest correlation with quality of life measures Stroke Impact Scale and 5 domain EuroQOL (ρ≥0.50, P<0.001). Prespecified prognostic factors were associated with SF-BI outcomes (all P<0.001). Our factor a...

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“…advanced cancer or advanced heart failure) that would make survival for 6 months unlikely Aphasia or cognitive impairment severe enough to prevent participation in the intervention. To assess this, participants will self-report their language and cognition from the relevant domains of the Short Stroke Impact Scale (SF-SIS) [26] ('In the past week, how difficult was it for you to think quickly'? and 'In the past week, how difficult was it to understand what was being said to you in a conversation'?).…”

Section: Exclusion Criteriamentioning

confidence: 99%

“…We will enquire whether antidepressants or anxiolytics have been prescribed -Self-reported fearful beliefs in relation to exercise, to determine if these are a mediator in the effect of CBT on post-stroke fatigue, measured using the fear avoidance questions from the Cognitive and Behavioural Responses Questionnaire (CBRQ) [36]. The decision to include the CBRQ was made after the trial was registered with the National Institutes of Health, as an amendment to our protocol -Stroke specific quality of life including participantreported social participation assessed using the Short Form of the Stroke Impact Scale (SF-SIS) [26] -Quality of life adjusted life years (QALYs) assessed using the Euroqol 5D (5-level version) [37].…”

Section: Potential Future Outcome Measures For An Efficacy Trialmentioning

confidence: 99%

Study protocol for POSITIF, a randomised multicentre feasibility trial of a brief cognitive-behavioural intervention plus information versus information alone for the treatment of post-stroke fatigue

Gillespie

Barber

Brady

et al. 2020

Pilot Feasibility Stud

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Background: Approximately, half of stroke survivors experience fatigue. Fatigue may persist for many months and interferes with participation in everyday activities and has a negative impact on social and family relationships, return to work, and quality of life. Fatigue is among the top 10 priorities for 'Life after Stroke' research for stroke survivors, carers, and clinicians. We previously developed and tested in a small uncontrolled pilot study a manualised, clinical psychologist-delivered, face-to-face intervention, informed by cognitive behavioural therapy (CBT). We then adapted it for delivery by trained therapists via telephone. We now aim to test the feasibility of this approach in a parallel group, randomised controlled feasibility trial (Post Stroke Intervention Trial In Fatigue, POSITIF). Methods/design: POSITIF aims to recruit 75 stroke survivors between 3 months and 2 years post-stroke who would like treatment for their fatigue. Eligible consenting stroke survivors will be randomised to either a 7-session manualised telephone-delivered intervention based on CBT principles plus information about fatigue, or information only. The aims of the intervention are to (i) provide an explanation for post-stroke fatigue, in particular that it is potentially reversible (an educational approach), (ii) encourage participants to overcome the fear of taking physical activity and challenge negative thinking (a cognitive approach) and (iii) promote a balance between daily activities, rest and sleep and then gradually increase levels of physical activity (a behavioural approach). Fatigue, mood, quality of life, return to work and putative mediators will be assessed at baseline (just before randomisation), at the end of treatment and 6 months after randomisation. POSITIF will determine the feasibility of recruitment, adherence to the intervention and the resources required to deliver the intervention in a larger trial.

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Derivation and Validation of a Modified Short Form of the Stroke Impact Scale

Cited by 26 publications

References 22 publications

Functional Assessment for Acute Stroke Trials: Properties, Analysis, and Application

Functional Assessment for Acute Stroke Trials: Properties, Analysis, and Application

Use of a 3-Item Short-Form Version of the Barthel Index for Use in Stroke

Study protocol for POSITIF, a randomised multicentre feasibility trial of a brief cognitive-behavioural intervention plus information versus information alone for the treatment of post-stroke fatigue

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