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Activities and participation after stroke: validity and reliability of the Turkish version of IMPACT-S questionnaire

Abstract Objective: This study aims to translate the screener part of the The International Classification of Functioning, Disability and Health (ICF) Measure of Participation and ACTivities Questionnaire (IMPACT-S) into Turkish and to test its reliability and validity in Turkish patients with stroke. Materials and methods: Participants were recruited from the inpatient rehabilitation clinic of a university hospital. Eighty-six stroke patients (mean ages: 60.43 ± 12.62 years; range 20–82 years; 51 males and 35 females) were included in the study. Demographic properties of the patients (age, sex, education, occupation, and body mass index), the start of in-patient rehabilitation treatment, affected extremity, types of stroke, and comorbidities were recorded. After that IMPACT-S questionnaire and World Health Organization Disability Assessment Schedule-II (WHODAS-II) were used for data collection. A test–retest interval of 7 d was used to assess the reliability. Internal consistency between the items was assessed by Cronbach’s alpha coefficient. For reliability; test–retest reliability, intraclass correlation coefficient (ICC), paired sample t-test were used. Intercorrelation of variables was performed with Spearman’s rho tests. Results: Totally 86 patients completed test/retest procedures. Cronbach’s alpha coefficient of the questionnaire was found to be 0.96. Both internal consistency (Cronbach’s alpha score range: 0.65–0.98) and test–retest reliability (ICC values range: 0.86–0.97) of the IMPACT-S were found to be good. The correlations between all IMPACT-S subscales were moderate to strong (correlation range: 0.45–0.80). The correlation between the Activities and Participation scores (0.86) and IMPACT-S total score (0.96) were very strong. Statistically significant negative correlations were detected between all sub-scores of IMPACT-S and WHODAS-II, except for life activities/communication and life activities/knowledge. These findings show excellent concurrent validity. However, a lower-than-expected correlation between Major life areas (IMPACT-S) and Life activities (WHODAS-II) was observed. Conclusion: The Turkish version of the IMPACT-S is a valid and reliable questionnaire for evaluating activities and participation in patients with stroke. Implications for rehabilitation Patients with stroke experience difficulties across multiple participation domains, such as major life areas and community life. The screener part of the IMpact on Participation and ACTivities (IMPACT-S) questionnaire is the only measure that accurately reflects The International Classification of Functioning, Disability and Health (ICF) sections and appears a promising outcome measure in rehabilitation research. The Turkish version of the IMPACT-S was found to be valid and reliable for evaluating “Activities and Participation” in stroke patients.