Abstract
Study design:
Multi-center, prospective, cohort study.
Objectives:
To assess the validity and reliability of the Spinal Cord Independence Measure (SCIM III) in measuring functional ability in persons with spinal cord injury (SCI).
Setting:
Inpatient rehabilitation hospitals in the United States (US).
Methods:
Functional ability was measured with the SCIM III during the first week of admittance into inpatient acute rehabilitation and within one week of discharge from the same rehabilitation program. Motor and sensory neurologic impairment was measured with the American Spinal Injury Association Impairment Scale. The Functional Independence Measure (FIM), the default functional measure currently used in most US hospitals, was used as a comparison standard for the SCIM III. Statistical analyses were used to test the validity and reliability of the SCIM III.
Results:
Total agreement between raters was above 70% on most SCIM III tasks and all κ-coefficients were statistically significant (P<0.001). The coefficients of Pearson correlation between the paired raters were above 0.81 and intraclass correlation coefficients were above 0.81. Cronbach’s-α was above 0.7, with the exception of the respiration task. The coefficient of Pearson correlation between the FIM and SCIM III was 0.8 (P<0.001). For the respiration and sphincter management subscale, the SCIM III was more responsive to change, than the FIM (P<0.0001).
Conclusion:
Overall, the SCIM III is a reliable and valid measure of functional change in SCI. However, improved scoring instructions and a few modifications to the scoring categories may reduce variability between raters and enhance clinical utility.
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References
Anderson K, Aito S, Atkins M, Biering-Sørensen F, Charlifue S, Curt A, Functional Recovery Outcome Measures Work Group et al. Functional recovery measures for spinal cord injury: An evidence-based review for clinical practice and research. J Spinal Cord Med 2008; 31: 133–144.
Catz A, Itzkovich M, Tesio L, Biering-Sorensen F, Weeks C, Laramee MT et al. A multi-center international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation. Spinal Cord 2007; 45: 275–291.
Itzkovich M, Gelernter I, Biering-Sorensen F, Weeks C, Laramee MT, Craven BC et al. The Spinal Cord Independence Measure (SCIM) version III: Reliability and validity in a multi-center international study. Disabil Rehabil 2007; 29: 1926–1933.
Anderson KD . Targeting recovery: priorities of the spinal cord injured population. J Neurotrauma 2004; 21: 1371–1383.
Stineman MG, Marino RJ, Deutsch A, Granger CV, Maislin G . A functional strategy for classifying patients after traumatic spinal cord injury. Spinal Cord 1999; 37: 717–725.
Middleton JW, Harvey LA, Batty J, Cameron I, Quirk R, Winstanley J . Five additional mobility and locomotor items to improve responsiveness of the FIM in wheelchair-dependent individuals with spinal cord injury. Spinal Cord 2006; 44: 495–504.
Ackerman P, Morrison SA, McDowell S, Vazquez L . Using the Spinal Cord Independence Measure III to measure functional recovery in a post-acute spinal cord injury program. Spinal Cord 2010; 48: 380–387.
Acknowledgements
We thank Thuy Pham and Ardi Gunawan for their extensive effort in coordinating the study and compiling all of the data. Additionally, all of the individuals at each of the sites, from administrators to raters to participants, are greatly appreciated, for this study would not have been possible without their cooperation. This work is funded by the Craig H Neilsen Foundation (CHNF-83492).
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Anderson, K., Acuff, M., Arp, B. et al. United States (US) multi-center study to assess the validity and reliability of the Spinal Cord Independence Measure (SCIM III). Spinal Cord 49, 880–885 (2011). https://doi.org/10.1038/sc.2011.20
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DOI: https://doi.org/10.1038/sc.2011.20
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