Elisabeth Ekstrand, Jan Lexell, Christina Brogårdh
Department of Health Sciences, Physiotherapy, Lund University, SE-221 00 Lund, Sweden. E-mail: elisabeth.ekstrand@med.lu.se
DOI: 10.2340/16501977-2378

Objective: To evaluate the test–retest reliability and variability of the Participation domain of the Stroke Impact Scale (SIS Participation) in persons with stroke as it is widely used to assess perceived participation in rehabilitation after stroke.
Design: A test–retest design.
Subjects: Forty-five persons (mean age 65 years) with mild to moderate disability at least 6 months post-stroke.
Methods: The SIS Participation domain was rated on 2 occasions, 1 week apart. The test–retest reliability of the total score was evaluated using Kappa statistics. The 8 item scores were evaluated by the proportion of participants who rated the same score (percentage agreement, PA) or ± 1 point (PA ≤ 1 point) at T1 and T2. The Svensson method was used to evaluate systematic and random disagreement.
Results: The test–retest reliability of the total score showed excellent agreement (Kappa coefficient = 0. 79). The items showed high PA ≤ 1 point (> 82%). No items, except 2, showed a systematic disagreement, and no items showed a random disagreement according to the Svensson method.
Conclusion: The SIS Participation domain is reliable in persons with chronic stroke and mild to moderate disability and can be used to assess perceived participation in this population.

After stroke, many persons perceive difficulties in resuming meaningful activities, social relations and being in control of their own lives. To address participation restrictions is therefore important in stroke rehabilitation. The Participation domain of the Stroke Impact Scale, SIS Participation, is commonly used to assess perceived restrictions in participation after stroke. The domain includes 8 items: impact of stroke on work; social activities; quiet recreations; active recreations; role as a family member and/or friend; religious or spiritual activities; ability of life control and ability to help others. This study shows that the SIS Participation domain is reliable and can be used to assess perceived participation after stroke.