Peiming CHEN ^1,2 Tai Wa Liu ³ Shamay S.M. Ng ^1,2*

• ¹ Research Centre for Chinese Medicine Innovation, Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
• ² Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Kowloon, Hong Kong, SAR China
• ³ School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, Hong Kong, SAR China

Objectives: This study aimed to assess the psychometric properties of the Chinese version of the Stay Independent Questionnaire (C-SIQ) in evaluating individuals with stroke. Design: The study adopted a cross-sectional design. Setting: The research was conducted at a university-based neurorehabilitation center. Participants: The study included a total of 100 individuals with stroke and 49 healthy older adults. Methods: On Day 1, both individuals with stroke and healthy older adults underwent assessments using the C-SIQ. Additionally, individuals with stroke were evaluated using the Fugl–Meyer Assessment of Lower Extremity (FMA-LE), ankle dorsiflexion and plantarflexion strength, Berg Balance Scale (BBS), Timed-Up and Go Test (TUG), 10-meter walk test (10mWT), Activities-specific Balance Confidence (ABC) Scale, Stroke Impact Scale (SIS), and Community Integration Measure (CIM). On Day 2 (7 days after Day 1), individuals with stroke were reassessed using the C-SIQ. Results: Individuals with stroke exhibited a higher C-SIQ score (6.22±2.98) compared to healthy older adults (1.59±2.01). The C-SIQ demonstrated good test-retest reliability (intraclass correlation coefficient = 0.847) and internal consistency (Cronbach's alpha = 0.709). The Minimal Detectable Change in C-SIQ score was calculated as 3.05. Exploratory factor analysis revealed four factors with eigenvalues ≥ 1.0, explaining 57.17% of the total variance. The C-SIQ score exhibited significant correlations (ranging from -0.553 to 0.362) with completion times of the TUG and 10mWT, FMA-LE, BBS, ABC, SIS, CIM score, paretic ankle dorsiflexion strength, and 6mWT distance. A cut-off score of 2.5 was identified as the optimal threshold for discriminating fall risk between individuals with stroke and healthy controls. Conclusion: The C-SIQ emerges as a reliable and valid tool for evaluating fall risk in individuals with stroke, showcasing strong correlations with key measures such as TUG times, 10mWT, FMA-LE, BBS, ABC, SIS, CIM score, paretic ankle dorsiflexion strength, and 6mWT distance. The C-SIQ demonstrated good test-retest reliability) and internal consistency. Exploratory factor analysis revealed that this is a four factors assessment tool. The identified cut-off score of 2.5 effectively distinguishes fall risk between individuals with stroke and healthy controls.