Rehab Measures - Medical Outcomes Study Short Form 36

Link to instrument

Available for purchase at SF-36.org (external link)

Title of Assessment

Medical Outcomes Study Short Form 36

Acronym

SF-36

Instrument Reviewer(s)

Initially reviewed by the Rehabilitation Measures Team; Updated by Wendy Romney, PT, DPT, NCS, Cara Weisbach, PT, DPT, and the SCI EDGE task force of the Neurology Section of the APTA in 2012; Updated by Sue Saliga PT, DHSc, CEEAA and the TBI EDGE task force of the Neurology section og the APTA in 2012

Summary Date

1/22/2013

Purpose

Generic, patient-report measure designed to assess health-related quality of life

Description

36 item measure divided into 8 subscales
The 8 subscales are:

(1) Physical Functioning
(2) Role Limitations due to Physical Problems
(3) General Health Perceptions
(4) Vitality
(5) Social Functioning
(6) Role Limitations due to Emotional Problems
(7) General Mental Health
(8) Health Transition

Respondents are asked to answers items referring to the past 4 weeks
Recommended scoring system for the SF-36 is a weighted Likert system for each item
Items within subscales are totaled to provide a summed score for each subscale or dimension.
Each of the 8 summed scores is linearly transformed onto a scale from 0 (negative health) to 100 (positive health) to provide a score for each subscale.
For each domain mean score = 50 and standard deviation = 10
Version 2 norms are based on the 1998 National Survey of Functional Health Status (NSFHS); more information on version 2 can be found on the SF-36 website: http://www.sf-36.org/tools/sf36html

Area of Assessment

Quality of Life

Body Part

Not Applicable

ICF Domain

Body Function; Activity; Participation

Domain

General Health

Assessment Type

Patient Reported Outcomes

Length of Test

06 to 30 Minutes

Time to Administer

10 minutes; 41 and 47 minutes, respectively, for individuals with paraplegia & tetraplegia (Anderson, et al 1999)

Number of Items

Equipment Required

None Necessary

Training Required

None Necessary

Type of training required

No Training

Cost

Not Free

Actual Cost

Contact QualityMetric Incorporated for information regarding licensing fees for your institution

Age Range

Adult: 18-64 years; Elderly adult: 65+

Administration Mode

Paper/Pencil

Diagnosis

Arthritis; Cardiac Conditions; Geriatrics; Multiple Sclerosis; Pain; Spinal Cord Injury; Stroke; Traumatic Brain Injury

Populations Tested

The following conditions each have 50 or more publications (Turner-Bowker et al, 2002):

Arthritis
Back pain
Low back pain
Multiple sclerosis
Musculoskeletal conditions
Neuromuscular conditions
Osteoarthritis
Rheumatoid arthritis
Spinal injuries
Stroke
Trauma
Traumatic Brain Injury (Nichol et al, 2011)

Standard Error of Measurement (SEM)

Mild Traumatic Brain Injury: (Emanuelson et al, 2003; n=117, patients assessed at 3 months post injury and n=101, patients assessed 1 year post-injury; age=16-60)

Domain in SF-36	Patients 3 Months (n = 117) Mean, SEM, median	Patients 1 Year (n = 101) Mean, SEM, median

Physical Function	85.4 (1.9), 95	87.5 (2.1), 95
Role Functioning:Physical	72.5 (3.5), 100	74.7 (3.8), 100
Bodily Pain	66.7 (3.0), 72	72.2 (3.1), 74
General Health	68.3 (2.4), 72	70.9 (2.5), 72
Vitality	59.3 (2.4), 60	62.3 (2.6), 65
Social Functioning	81.6 (2.5), 100	83.2 (2.4), 100
Role Functioning: Emotional	72.7 (2.4), 80	77.2 (3.7), 100
Mental Health	71.2 (2.4), 80	74.9 (2.2), 84
Physical Composite	48.4 (1.2), 52	49.1 (1.1), 52
Mental Composite	44.8 (1.2), 48	46.5 (1.3), 51

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Applicable

Normative Data

Chronic Stroke: (Anderson et al, 1996; n = 90; mean age = 72 (12) years; assessed 1 year post stroke; Australian version)

SF-36 Domain	Mean	SD
Physical functioning	48	33
Role limits–physical	76	34
Bodily pain	76	28
General health	64	22
Vitality	56	20
Social functioning	86	23
Role limits–emotional	83	31
Mental health	77	22

Chronic Spinal Cord Injury: (Forchheimer et al, 2004; n=215, mean age= 38.8 years; assessed > 1 year post traumatic SCI)

SF-36 Domain	Mean	SD
Physical functioning	26.6	11.5
Role Physical	40.7	10.9
Bodily pain	42.2	12.4
General Health	44.4	11.8
Vitalitiy	46.8	9.6
Social Functioning	43.0	13.3
Role Emotional	49.0	10.6
Mental Health	48.3	11.0
Physical Component Summary	33.5	10.1
Mental Component Summary	53.5	11.6

TBI: (Colantonio et al., 1998; n = 51; mean age = 18.28 (2.04) years; assessed 5 years post TBI )

	Mild (n=24)		Moderate /Severe (n=27)
	Mean	SD	Mean	SD
Physical Functioning	84.91	22.02	75.43	35.43
Role Limits–physical	79.17	36.94	75.32	37.01
Bodily Pain	77.40	19.29	81.44	17.89
General Health	63.98	26.74	68.33	22.74
Vitality	53.54	9.83	52.90	13.79
Social Functioning	72.92	27.25	73.15	27.23
Mental Health	46.50	16.42	46.67	17.40
Role Limits–mental health	81.94	32.57	75.64	38.36

Mild Traumatic Brain Injury: (Emanuelson et al, 2003; n=117, patients assessed at 3 months post injury and n=101, patients assessed 1 year post injury; age=16-60)

Domain in SF-36	Patients 3 Months (n = 117) Mean, SEM, median	Patients 1 Year (n = 101) Mean, SEM, median	Mean	SD	Median	Minimum	Maximum

PF	85.4 (1.9), 95	87.5 (2.1), 95	0.85	12.93	0.00	−35.00	60.00
RF	72.5 (3.5), 100	74.7 (3.8), 100	−0.42	30.07	0.00	−100.00	100.00
BP	66.7 (3.0), 72	72.2 (3.1), 74	1.31	25.52	0.00	−69.00	69.00
GH	68.3 (2.4), 72	70.9 (2.5), 72	0.78	17.67	0.00	−52.00	48.00
VT	59.3 (2.4), 60	62.3 (2.6), 65	1.86	19.97	0.00	−70.00	60.00
SF	81.6 (2.5), 100	83.2 (2.4), 100	−0.12	20.35	0.00	−62.50	50.00
RE	72.7 (2.4), 80	77.2 (3.7), 100	3.00	33.87	0.00	−100.00	100.00
MH	71.2 (2.4), 80	74.9 (2.2), 84	1.74	17.87	0.00	−48.00	56.00
PCS	48.4 (1.2), 52	49.1 (1.1), 52	−0.02	6.80	−0.06	−23.16	18.94
MCS	44.8 (1.2), 48	46.5 (1.3), 51	1.09	10.43	0.47	−36.97	36.67

PF =physical functioning, RF =role physical, BP =bodily pain, GH =general health, VT =vitality, SF = social functioning, RE =role emotional, MH =mental health, PCS =physical composite score, MCS =mental composite score.

Test-retest Reliability

Chronic Stroke: (Dorman et al, 1998; n = 209; 3 weeks between assessments; mean time since stroke onset 64(30) weeks)

Domain	Patient ICC's	Proxy ICC's	Combined ICC's
Physical Functioning	0.80	0.59	0.74
Role Limits–physical	0.77	0.45	0.67
Bodily Pain	0.81	0.65	0.75
General Health	0.81	0.71	0.79
Vitality	0.77	0.55	0.70
Social Functioning	0.79	0.76	0.80
Role Limits–emotional	0.60	0.50	0.57
Mental Health	0.30	0.24	0.28

Chronic Traumatic Spinal Cord Injury : (Lin et al, 2007; n=187; 4 weeks between assessments; mean time since injury was 7.8 years)

20 random participants were selected to assess their original responses within 2 weeks; n=10 by same interviewer (intra interviewer), n=10 with a second interviewer (inter interviewer)

SF-36 Domain	Intra interviewer (ICC)	Inter interviewer (ICC)
Physical Functioning	0.71	0.67
Role Physical	0.89	0.90
Bodily Pain	0.87	0.70
General Health	0.85	0.41
Vitality	0.93	0.86
Social Functioning	0.93	0.52
Role Emotional	0.99	0.98
Mental Health	0.77	0.57
Excellent Intra ICC > 0.9 in BOLD; Excellent Inter ICC > 0.7 in BOLD

Interrater/Intrarater Reliability

Not applicable

Internal Consistency

Acute Stroke: (Hagen et al, 2003; n = 136; mean age = 70 (11) years; assessed 1, 3 and 6 months post-stroke)

Adequate to Excellent internal consistency across domains (alpha > 0.70) over multiple administrations (1, 3 and 6 months) except Vitality at 1 month post stroke (a = 0.6824) and General Health at 3 months post-stroke (a = 0.6650)

Chronic Stroke: (Anderson et al, 1996)

Excellent internal consistency (Cronbach's alpha >0.7, except Vitality section):

SF-36 Domain
Strength
alpha

Physical Functioning
Excellent
0.9

Role Limits–physical
Adequate
0.8

Bodily Pain
Excellent
0.9

General Health
Adequate
0.7

Vitality
Adequate
0.6

Social Functioning
Adequate
0.7

Role Limits–emotional
Excellent
0.9

Mental Health Adequate
0.7

Spinal Cord Injury: (Forchheimer,et al 2004)

Adequate to Excellent internal consistency across all domains (Chronbach’s α = 0.76 to 0.90, mean = 0.82)

SF-36 Domain	Internal Consistency (Cronbach’s alpha)
Physical Functioning	0.98
Role Physical	0.94
Bodily Pain	0.79
General Health	0.82
Vitality	0.76
Social Functioning	0.72
Role Emotional	0.89
Mental Health	0.78
Excellent internal consistency > 0.80 in BOLD; Adequate internal consistency 0.70-0.80

Chronic SCI: (van Leeuwen et al 2012, n=145, AIS A-D, 5 years post injury)

Adequate internal consistency of the Mental Health subscale of SF-36 (MHI-5), Cronbach’s α =0.79

Traumatic Brain Injury: (Mackenzie, et al 2002, n =1230 (1197 without proxy, 33 by proxy), age range 18-54 years, gender=male 66%)

The α coefficient for the SF-36 health survey with the cognitive function scale

SF-36 Domain	α coefficient	Strength
Physical Functioning	0.93	Excellent
Role Limits–physical	0.88	Excellent
Bodily Pain	0.89	Excellent
General Health	0.77	Adequate
Vitality	0.84	Excellent
Social Functioning	0.82	Excellent
Role Limits–emotional	0.87	Excellent
Mental Health	0.88	Excellent

Traumatic Brain Injury: (Findler et al; n=597 (without disability, n=271; mild TBI, n=98; moderate-severe TBI, n=228); Mean age at interview=no disability, 38.5(12.7); mild TBI, 41.7(10.8), moderate-severe TBI, 35.7(9.8)

Cronbach’s alpha ranged from 0.68-0.87 (adequate to excellent) for the comparison group , from 0.83-0.91 (excellent) for the mild TBI group, and from 0.79-0.92 (adequate to excellent) for the moderate-severe TBI group

Traumatic Brain Injury: (Guilfoyle et al, 2011; n=514; mean age=36.6 (16.1) years; gender=male 76.3%)

SF-36 domain	Alpha coefficient	Strength
Physical Function	0.95	Excellent
Role Physical	0.89	Excellent
Bodily Pain	0.90	Excellent
General Health	0.83	Excellent
Vitality	0.83	Excellent
Social function	0.82	Excellent
Role Emotional	0.90	Excellent
Mental Health	0.86	Excellent

Criterion Validity (Predictive/Concurrent)

Chronic Stroke: (Dorman et al, 1999; n = 688)

Adequate concurrent validity between the EuroQol health-related quality of life and the SF-36's general health domain r = 0.66
Poor concurrent validity between SF-36 mental health domain and the EuroQol psychological functioning subtest
Excellent to Poor correlations between individual Barthel Index scores at five years and dimensions of the SF36. (Wilkinson et al, 1997; UK sample, n = 97, mean age at stroke = 61, mean follow-up 4.9 years)

SF36

r =

Physical functioning

0.810

Social functioning

0.481

Role: physical

0.415

Role: emotional

0.217

Mental health

0.332

Vitality

0.500

Bodily pain

0.356

General health

0.438

Chronic SCI: (Van Leeuwen et al 2012)

Concurrent Validity	Spearman Correlation
LiSat 9	0.531ᵃ
Neuroticism	-0.546ᵃ
SF- Vitality	0.528ᵃ
SF- general health	0.367ᵃ
Divergent Validity
FIM	0.094
SIP-mobility range	-0.283
Type of injury	-0.009
Completeness of injury	-0.008
Cause of injury	0.192
Demographics
Age	-0.020
Gender	-0.067
Education	0.028
ᵃ=Adequate validity 0.31-0.59; Poor validity ≤ 0.30; VanLeeuwen anticipated poor correlations with Demographics and injury

Construct Validity (Convergent/Discriminant)

Chronic Spinal Cord Injury: (Forchheimer, et al 2004)

Excellent discriminant validity established between Physical capacity score (PCS) and Mental capacity score (MCS) constructs ( -0.075)
Excellent convergent validity between impairment severity and PCS (F= 5.62, df=3, P= 0.001)
Excellent Divergent validity between impairment severity and MCS scores (F=0.175, df=3, P =NS)

Chronic Spinal Cord Injury : (Lin et al, 2007)

		WHOQOL-BREF
SF-36	Rating Scale	Overall	Physical Capacity	Psych	Social	Environ
Rating Scale	---	0.68	0.73	0.64	0.54	0.57
Physical Functioning	0.71	0.57	0.78	0.57	0.50	0.54
Role physical	0.47	0.35	0.51	0.40	0.33	0.48
Bodily pain	0.64	0.52	0.68	0.56	0.48	0.55
General Health	0.72	0.65	0.69	0.62	0.45	0.59
Vitality	0.59	0.59	0.67	0.65	0.48	0.62
Social Functioning	0.50	0.52	0.62	0.63	0.43	0.58
Role Emotional	0.32	0.30	0.41	0.37	0.24	0.39
Mental Health	0.36	0.51	0.52	0.59	0.40	0.56
Excellent correlation > 0.60 in BOLD; Adequate correlation .31-.59; Excellent to Adequate convergent validity between SF-36 and WHOQOL-BREF subscales

Chronic Spinal Cord Injury : (Anderson et al, 1999 n=181 veterans with SCI who were hospitalized within 6 months of assessment)

Excellent to adequate correlations between SF-36 and Behavioral Risk Factor Surveillance System (BRFSS) subscales
Mental Capacity Summary to all BRFSS subscales (r= -0.427—0.761 )
Mental Health subscale to all BRFSS subscales (r= -0.446- -0.795)
Vitality subscale to all BRFSS subscales (r= -0.450 - -0.789)
Social Functioning subscale to all BRFSS (r= -0.293 - -0.622)
Role Emotional subscale to all BRFSS (r= -0.290- -0.610)
Poor to adequate correlations between SF-36 subscales Physical Functioning, Role Physical, Bodily Pain, General Health and Physical Summary and all BRFSS subscales (r= 0.065- 0.597)
Poor to adequate correlations between SF-36 and Quality of Well Being (r= 0.044 to 0.417) (poor ≤0.03; adequate 0.31-0.59)
Adequate to Poor correlation between SF-36 and IADLs (r= -0.159- to -0.454)

Traumatic Brain Injury: (Findler et al; n=597 (without disability, n=271; mild TBI, n=98; moderate-severe TBI, n=228); Mean age at interview=no disability, 38.5(12.7); mild TBI, 41.7(10.8), moderate-severe TBI, 35.7(9.8)

Mild TBI:

Adequate to excellent correlations (-0.50 to -0.63) were found between SF-36 scales pertaining directly to physical functioning (General Health, Physical Functioning, Physical Role, Bodily Pain, Vitality) and the Physical symptoms scale of the Symptoms Checklist (SCL)
Excellent correlations between SF-36 scales and participants’ Health Problems List (HPL) responses (-0.60 to -0.75)
Emotional Role and Mental Health scores were more strongly related to psychological factors (Cognitive and Affective/Behavioral) than to physical factors on the Symptom Checklist (SCL)

Adequate to excellent correlations (-0.52 to -0.77) were found between Beck Depression Inventory second edition (BDI-II) scores and the SF-36 subscales

Moderate to Severe TBI:

Correlations were lower and more uniform, strongest correlations found between the SF-36 Emotional Role scale and the SCL Affective/Behavioral scale (-0.53).
Correlations between the Physical Functioning scale of the SF-36 and the Cognitive and Affective/Behavioural scales of the SCL were lower than other correlations between scales within this group (-0.11 and -0.19, respectively).

Multiple Neurologic Diagnosis (polio, acute stroke, and TBI): McNaughton et al., 2005; n=308, Polio n=38, Stroke n=181, TBI n=89; mean age=polio 62.5 (11.3), stroke=74.4 (12.0), TBI=34.0 (17.8); gender, female=polio 27%, stroke 96%, TBI 32%)

examined validity of the mental component score (MCS) and physical component score (PCS)
Principal component analysis (PCA) on the 12-month measures for subjects with stroke and TBI: 2 dimensions might account for a large proportion of the variability in the data set
Varimax rotation shows that the 2-factor model has 85% of the variance of the underlying variables with 1 factor loading mainly onto the Barthel Index, Functional Independence Meausre (FIM), PCS,Community Integration Questionnaire (CIQ), and London Handicap Scale (LHS) and the other factor mainly onto the MCS

Traumatic Brain Injury: (Guilfoyle et al; n=514; mean age=36.6 (16.1) years; gender=male 76.3%)

Principal component analysis (PCA) of the correlation matrix of the eight SF-36 domains extracted a single PC with an eigenvalue exceeding unity, which explained 59.2% of the variance in the data
The second PC extracted had an associated eigenvalue of 0.75, and accounted for only 9.4% of the variance

Known Groups

mild TBI and moderate to severe TBI groups reported significantly lower health status across all scales compared to the comparison group
mild TBI group reported significantly lower scores (poorer health)on all scales compared to the moderate± severe TBI group, with the exception of Physical Function, where there were no differences between the two groups

Traumatic Brain Injury: (Jacobsson et al., 2010 n=67, mild TBI n=32, moderate to severe TBI n=35; mean age at time of injury=mild TBI:13 (13) years, moderate to severe TBI: 30 (12) years); gender=mild TBI: male75%, moderate to severe TBI: male 77%; Swedish version of the SF-36)

	SF-36PCS	MCS	SWLS	Sex	Age at Injury	Injury Severity	Time since injury	Marital status	Vocational situation
SF-36: MCS	-0.00
SWLS	0.41**	0.48**
Sex	-0.19	0.01	-0.02
Age at injury	-0.14	0.29*	0.05	0.23
Injury severity	0.20	-0.10	-0.06	-0.03	0.32**
Time since injury	0.13	0.06	0.30*	-0.05	-0.15	0.10
Marital status	0.11	0.06	0.36**	-0.01	-.18	-0.11	0.08
Vocational situation	0.48**	-0.02	0.32**	-0.11	-0.37**	0.13	0.11	0.21
Self appraisal of the TBI	-0.54**	-0.12	-0.46**	0.09	-0.05	-0.31**	-0.04	-0.27*	-0.35**

Correlation (Spearman’s rho) is significant (two-tailed) on *0.05, and **0.01 levels

SWLS-Satisfaction With Life Scale

Content Validity

Items that compose the SF-36 were drawn from a number of prior measures including:

The General Psychological Well-Being Inventory (GPWBI) (Dupuy, 1984)
Physical and role functioning measures (Patrick, Bush, & Chen, 1973; Hulka & Cassel, 1973; Reynolds, Rushing, & Miles, 1974; Stewart, Ware, & Brook, 1981)
The Health Perceptions Questionnaire (HPQ) (Ware, 1976)
The Functioning and Well-Being Profile (FWBP) (Stewart & Ware, 1992)

Face Validity

Not statistically assessed

Floor/Ceiling Effects

Acute Stroke: (Hagen et al, 2003; n = 153; 1 month post stroke)

SF-36 Domain

% Floor

% Ceiling

Physical Functioning

23

1

Role Physical

70

4

(Lack of) Bodily Pain

6

35

General Health

0

3

Vitality

4

0

Social Functioning

27

16

Role Emotional

37

26

Mental Health

0

2

Chronic Stroke: (Anderson et al, 1996)

The SF-36 avoids the "ceiling effect" of most disability scales:

SF-36 Domain	% floor	% ceiling
Physical Functioning	4	6
Role Physical	7	53
(Lack of) Bodily Pain	2	43
General Health	2	2
Vitality	1	1
Social Functioning	3	67
Role Emotional	7	72
Mental Health	1	4

Traumatic Brain Injury: (Guilfoyle et al, 2011; n=514; mean age=36.6 (16.1) years; gender=male 76.3%)

Floor effects were observed in two domains—Role Physical and Role Emotional—and ceiling effects were observed in four domains—Physical Function, Role Physical, Bodily Pain, and Role Emotional

SF-36 domain	Floor %	Ceiling %
Physical Function	4.7%	16.7
Role Physical	56.8	19.1
Bodily Pain	2.0	21.4
General Health	0.2	5.1
Vitality	2.2	2.8
Social function	7.3	0.0
Role Emotional	43.9	37.5
Mental Health	0.6	4.0

Responsiveness

Chronic spinal cord injury: (Lin et al, 2007)

Highly sensitive (ES =0.60& 0.92) with respect to employment status with Physical Functioning and Role Physical domains.
Moderately sensitive (ES =0.21-0.44) with respect to employment status with Social Functioning, Role Emotional and Mental Health domains
Small responsiveness (ES= 0.00-0.16)with respect to employment status in Bodily Pain, General Health, and Vitality domains.

Mild Traumatic Brain Injury (mTBI): (Paniak et al.,1999; n=120 with mild TBI, 120 control group; mean age=mTBI 32.7 (11.9), control 30.4 (11.6))

SF 36 variable	Effect Size
Physical Functioning	3.5	Moderate change
Social	1.98	Small change
Role Functioning Physical	2.72	Moderate change
Bodily Pain	2.04	Moderate change
Mental Health	0.90	Small change
Role Functioning Emotional	0.96	Small change
Vitality	1.78	Small change
General Health	0.18	Small change
Mental	0.93	Small chage
Physical	2.48	Moderate change

Traumatic Brain Injury: (Hawthorne et al, 2009; n=66; mean age at time of injury=36 (15); mean time since injury=32 months; utilized SF-36 version 2)

SF 36 variable	Effect Size
Physical Functioning	-0.56
Role Functioning Physical	-0.77
Bodily Pain	-0.38
General Health	-0.44
Vitality	-0.43
Social Function	-0.81
Role Functioning Emotional	-0.86
Mental Health	-0.70
Physical	-0.47
Mental	-0.76

The largest effect sizes were for sub-scales assessing social, emotional, and mental health, but there were moderate to large effects across all of the eight sub-scales, suggesting that TBI may have very broad effects across many different life parts.

Professional Association Recommendations

Considerations

Physical function domain: significant floor effects for patients with SCI and other disabilities due to inability to perform some of the physical tasks described. Recommend the SF-36 state “walkwheel” to improve responsiveness for patients with spinal cord injury. (Lee et al. ,2009)

Not recommended for:

Patients who cannot understand written or spoken language
Severely affected stroke survivors who require a proxy to complete the assessment
To document patient change (Dorman et al., 1999)
Some disadvantaged populations, slight declines in reliability may result (Turner-Bowker et al., 2002)
Postal administration of the SF-36 is not recommended (O'Mahony et al, 1998)

The Mental Health Subscale of SF-36 (MHI-5) VanLeeuwen, 2012 may be used in the future to determine mental health and severe mental health problems in persons with SCI. Cut off score ≤72 and ≤60 respectively.

The SF-12 is a shorter version of the SF-36 containing 12 items; covers the summary physical health and mental health scales, but no information about each of the eight dimensions of the SF-36
The SF-12 is beginning to be more commonly used in the TBI population however its psychometric properties in this population have not been specifically assessed (Nichol et al, 2011)

Bibliography

Anderson, C., Laubscher, S., et al. (1996). "Validation of the Short Form 36 (SF-36) health survey questionnaire among stroke patients." Stroke 27: 1812-1816. Find it on PubMed

Andresen, E. M., Fouts, B. S., et al. (1999). "Performance of health-related quality-of-life instruments in a spinal cord injured population." Archives of physical medicine and rehabilitation 80(8): 877.

Dorman, P., Slattery, J., et al. (1998). "Qualitative comparison of the reliability of health status assessments with the EuroQol and SF-36 questionnaires after stroke. United Kingdom Collaborators in the International Stroke Trial." Stroke 29: 63-68. Find it on PubMed

Dorman, P. J., Dennis, M., et al. (1999). "How do scores on the EuroQol relate to scores on the SF-36 after stroke?" Stroke 30: 2146-2151. Find it on PubMed

Emanuelson, I., Andersson Holmkvist, E., et al. (2003). "Quality of life and post-concussion symptoms in adults after mild traumatic brain injury: a population-based study in western Sweden." Acta Neurol Scand 108(5): 332-338. Find it on PubMed

Findler, M., Cantor, J., et al. (2001). "The reliability and validity of the SF-36 health survey questionnaire for use with individuals with traumatic brain injury." Brain Inj 15(8): 715-723. Find it on PubMed

Forchheimer, M., McAweeney, M., et al. (2004). "Use of the SF-36 among persons with spinal cord injury." Am J Phys Med Rehabil 83(5): 390-395. Find it on PubMed

Guilfoyle, M. R., Seeley, H. M., et al. (2010). "Assessing quality of life after traumatic brain injury: examination of the short form 36 health survey." J Neurotrauma 27(12): 2173-2181. Find it on PubMed

Hagen, S., Bugge, C., et al. (2003). "Psychometric properties of the SF-36 in the early post-stroke phase." J Adv Nurs 44: 461-468. Find it on PubMed

Jacobsson, L. J., Westerberg, M., et al. (2010). "Health-related quality-of-life and life satisfaction 6-15 years after traumatic brain injuries in northern Sweden." Brain Inj 24(9): 1075-1086. Find it on PubMed

Lee, B. B., Simpson, J. M., et al. (2009). "The SF-36 walk-wheel: a simple modification of the SF-36 physical domain improves its responsiveness for measuring health status change in spinal cord injury." Spinal Cord 47(1): 50-55. Find it on PubMed

Lin, M. R., Hwang, H. F., et al. (2007). "Comparisons of the brief form of the World Health Organization Quality of Life and Short Form-36 for persons with spinal cord injuries." American journal of physical medicine & rehabilitation 86(2): 104-113.

MacKenzie, E. J., McCarthy, M. L., et al. (2002). "Using the SF-36 for characterizing outcome after multiple trauma involving head injury." The Journal of Trauma and Acute Care Surgery 52(3): 527-534.

McNaughton, H. K., Weatherall, M., et al. (2005). "Functional measures across neurologic disease states: analysis of factors in common." Arch Phys Med Rehabil 86(11): 2184-2188. Find it on PubMed

O'Mahony, P. G., Rodgers, H., et al. (1998). "Is the SF-36 suitable for assessing health status of older stroke patients?" Age Ageing 27: 19-22. Find it on PubMed

Paniak, C., Phillips, K., et al. (1999). "Sensitivity of three recent questionnaires to mild traumatic brain injury-related effects." J Head Trauma Rehabil 14(3): 211-219. Find it on PubMed

Turner-Bowker, D., Bartley, P., et al. (2002). "SF-36® Health Survey & “SF” Bibliography:(1988–2000)." Lincoln, RI: Quality Metric Incorporated.

van Leeuwen, C. M., van der Woude, L. H., et al. (2012). "Validity of the mental health subscale of the SF-36 in persons with spinal cord injury." Spinal Cord 50(9): 707-710. Find it on PubMed

Wilkinson, P. R., Wolfe, C. D., et al. (1997). "Longer term quality of life and outcome in stroke patients: is the Barthel index alone an adequate measure of outcome?" Qual Health Care 6: 125-130. Find it on PubMed

Year published

1992

Instrument in PDF Format

Approval Status

Approved

Attachments