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Measurement Characteristics and Clinical Utility of the Walking Index for Spinal Cord Injury

      Patients, clinicians, and researchers all aim to maximize recovery of walking after a spinal cord injury (SCI).1 To demonstrate improvement in walking ability, professionals need a reliable, valid, and responsive scale to measure progress. The Walking Index for Spinal Cord Injury (WISCI, revised to WISCI II2) is a scale developed by experts specifically for the SCI population to assess walking ability.3 It is an ordinal scale considering the amount of assist, assistive devices, and braces required to walk 10m, where 0 is unable to walk and 20 is able to walk 10m with no devices, braces, or assist.2,3 The WISCI II has excellent clinical utility and psychometrics, including data indicating a change in one level is considered a real difference.3-6 In individuals with higher walking ability, and further postinjury, the WISCI II is less sensitive to change than timed walking tests, and can potentially have a ceiling effect.7,8 However, the WISCI II is a valued complement to the timed tests. Collecting WISCI II scores, along with timed tests, can be helpful in identifying ways in which a person has improved walking, due to a decrease or change in assist and devices, or due to velocity changes.7
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