Measurement Characteristics and Clinical Utility of the Craig Handicap Assessment and Reporting Technique Among Individuals With Spinal Cord Injury

      Community reintegration after spinal cord injury (SCI) is usually a rehabilitation goal. Assessment of an individual's level of community reintegration involves understanding multiple variables, including physical independence, cognitive independence, mobility, occupation, social integration, and economic self-sufficiency.1 The Craig Handicap Assessment and Reporting Technique (CHART) is a patient-reported measure that assesses how individuals with a disability participate as active members of their communities. Each domain is assessed by the 32-item instrument, and has a maximum score of 100 per domain. The total score on the CHART is a summation of each domain score, with a maximum score of 600. Higher scores on the CHART indicate a greater degree of social and community participation. The CHART is free, can be completed in less than 10 minutes, and does not require training prior to administration. Psychometric studies have indicated that the CHART demonstrates adequate to excellent reliability and validity in SCI samples.
      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the CHART in the SCI population, including reliability, validity, and normative values. A full review of the CHART and a link to testing documents can be found at
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        Gontkovsky ST, Russum P, Stokic DS. Comparison of the CIQ and CHART Short Form in assessing community integration in individuals with chronic spinal cord injury: a pilot study. NeuroRehabilitation 2009;24:185-92.
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        Tozato F, Tobimatsu Y, Wang CW, Iwaya T, Kumamoto K, Ushiyama T. Reliability and validity of the Craig Handicap Assessment and Reporting Technique for Japanese individuals with spinal cord injury. Tohoku J Exp Med 2005;205:357-66.
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        Whiteneck GG, Charlifue SW, Gerhart KA, Overholser JD, Richardson GN. Quantifying handicap: a new measure of long-term rehabilitation outcomes. Arch Phys Med Rehabil 1992;73:519-26.
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        Walker N, Mellick D, Brooks CA, Whiteneck GG. Measuring participation across impairment groups using the Craig Handicap Assessment Reporting Technique. Am J Phys Med Rehabil 2003;82:936-41.
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        Hall KM, Dijkers M, Whiteneck G, Brooks C, Stuart Krause J. The Craig handicap assessment and reporting technique (CHART): metric properties and scoring. Top Spinal Cord Inj Rehabil 1998;4:16-30.
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        Dijkers M. Scoring CHART: survey and sensitivity analysis. J Am Paraplegia Soc 1991;14:85-6.
      This instrument summary is designed to facilitate the selection of outcome measures by trained clinicians. The information contained in this summary represents a sample of the peer-reviewed research available at the time of this summary's publication. The information contained in this summary does not constitute an endorsement of this instrument for clinical practice. The views expressed are those of the summary authors and do not represent those of authors' employers, instrument owner(s), the Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the United States Department of Education. The information contained in this summary has not been reviewed externally.
      The Rehabilitation Measures Database and Instrument Summary Tear-sheets are funded by the National Institute on Disability and Rehabilitation Research, United States Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (H133B090024).