Stroke Impact Scale and Impact on Activities – Occupational Therapy

Stroke survivors may have changes in their participation of activities that they usually do and that are meaningful to them. This depends on the extent of the stroke, prior levels of function, other changes after stroke, physical factors, and mental factors. Measures such as the Stroke Impact Scale (SIS) can provide insight into the patient’s perspective on how they have been affected by a stroke.((Carod-Artal, F. J., Coral, L. F., Trizotto, D. S., & Moreira, C. M. (2008). The stroke impact scale 3.0: evaluation of acceptability, reliability, and validity of the Brazilian version. Stroke, 39(9), 2477-2484.))

Common activities which may be affected in addition to ADLs an IADLs include:

  • Work (paid, voluntary, other)
  • Socialization (person to person, virtual)
  • Recreation and leisure
  • Roles (family, friend, student, etc.)
  • Spiritual and religious activities

While we often address ADLs and IADLs in rehabilitation, other activities such as those above may often be neglected. This may be in part due to factors such as the healthcare system, insurance, or even the culture of therapy where occupational therapists may practice.

Self-reported measures such as the Stroke Impact Scale (SIS) may help practitioners gain insight into the impact that a stroke may have had on the patient. Another component that is part of the SIS is the general question that patients self-rate from 0-100 their perceived level of recovery from ‘no recovery’ to ‘full recovery’.

Even if patients overestimate their abilities, measures such as the SIS help provide us insight into the patient’s perceived impact and level of functioning after stroke. Repeated measures can provide another data point to show change and improvements for patients such as after a stroke.

Areas of the SIS assessment include ADLs, cognition, communication, life participation, quality of life, social relationships, and social support. It has been adapted culturally for other languages and shows initial evidence of validity. It is free to use for non-profit clinicians.