Translation and validation of stroke impact scale-16 in Urdu for Pakistan

Ahmed U., Karimi H., Gilani S. A., Ahmad A.

Journal of the Pakistan Medical Association, vol.72, no.8, pp.1502-1506, 2022 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 72 Issue: 8
  • Publication Date: 2022
  • Doi Number: 10.47391/jpma.3151
  • Journal Name: Journal of the Pakistan Medical Association
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Page Numbers: pp.1502-1506
  • Keywords: Patient reported outcome measures, Quality of life, Stroke
  • Istanbul Gelisim University Affiliated: Yes


Objective: To translate and validate the Urdu version of stroke impact scale-16 for Pakistani society. Method: The prospective cohort study was conducted from February 2018 to February 2020 after approval from the ethics review board of The University of Lahore, Lahore, Pakistan, and copmprised patients with mild to moderate stroke who were recruited from five public and two private hospitals of the Punjab province. Established guidelines were followed to translate the Stroke Impact Scale-16. The patients were concurrently evaluated on Barthel Index, Stroke Rehabilitation Assessment of Movement, Modified Rivermead Mobility Index, Modified Rankin Scale, Short Form 36 Health Survey Questionnaire and the Hospital Anxiety and Depression Scale to assess the validity of Stroke Impact Scale-16, and spearmen correlation coefficient was used to determine the correlation among the scales. Analysis of variance was employed to determine the discriminant validity. Intraclass correlation coefficient, weighted kappa, Cronbach's alpha and item-total correlation were calculated to establish the stability and consistency of Stroke Impact Scale-16. Data was analysed using SPSS 25. Results: Of the 90 patients, 50(55.5%) were females and 40(45.5%) were males. The subjects were aged 50-80 years. The correlation of Stroke Impact Scale-16 was strong with the established tools and ranged from 0.78 to 0.91. The discriminant validity was also significant (p<.001) across all Modified Rankin Scale levels. The Intraclass correlation coefficient was 0.94 and Cronbach's alpha was 0.91 for test-retest reliability and internal consistency, respectively. All corrected item-total correlation values exceeded the priori minimum standard (>0.40) and ranged from 0.51 to 0.68. The weighted kappa for item reliability also achieved priori criteria (>0.40) and ranged from 0.53 to 0.88. Conclusion: With slight modifications, the Urdu version of Stroke Impact Scale-16 was found to have satisfactory psychometric properties and can be used in clinical and research settings for stroke survivors in Pakistan.