Advertisement

Measurement Characteristics and Clinical Utility of the Spinal Cord Independence Measure-III Among Individuals With Spinal Cord Injury

      The Spinal Cord Independence Measure–III (SCIM-III) was specifically developed for use in patients with spinal cord injuries to assess their ability to complete routine daily tasks and activities of daily living.
      • Catz A.
      • Itzkovich M.
      • Agranov E.
      • Ring H.
      • Tamir A.
      SCIM - Spinal Cord Independence Measure: a new disability scale for patients with spinal cord lesions.
      The SCIM-III is a clinician-rated instrument comprised of 19 items across 3 subscales: (1) self-care, (2) respiration and sphincter management, and (3) mobility, with items being weighted according to assumed clinical importance. The SCIM-III has shown to be a reliable and valid instrument for the functional evaluation of individuals with spinal cord injuries
      • Itzkovich M.
      • Gelernter I.
      • Biering-Sorensen F.
      • et al.
      The Spinal Cord Independence Measure (SCIM) Version III: reliability and validity in a multi-center international study.
      • Catz A.
      • Itzkovich M.
      • Tesio L.
      • et al.
      A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation.
      • 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).
      and has been endorsed by relevant stakeholders and outcomes assessment experts for use in clinical and research contexts.
      • Furlan J.
      • Noonan V.
      • Singh A.
      • Fehlings M.
      Assessment of disability in patients with acute traumatic spinal cord injury: a systematic review of the literature.
      • Anderson K.
      • Aito S.
      • Atkins M.
      • et al.
      Functional recovery measures for spinal cord injury: An evidence-based review for clinical practice and research.
      • Alexander M.
      • Anderson K.
      • Biering-Sorensen F.
      • et al.
      Outcome measures in spinal cord injury: recent assessments and recommendations for future directions.
      This measure has been shown to be responsive to functional change from admission to discharge and has demonstrated excellent concurrent validity with FIM scores.
      • Bluvshtein V.
      • Front L.
      • Itzkovich M.
      • et al.
      SCIM III is reliable and valid in a separate analysis for traumatic spinal cord lesions.
      Minimal detectable change and minimal important difference scores for the SCIM-III have been established,
      • Scivoletto G.
      • Tamburella F.
      • Laurenza L.
      • Molinari M.
      The Spinal Cord Independence Measure: how much change is clinically significant for spinal cord injury subjects.
      and expected scores for various neurologic levels in spinal cord injury have been reported.
      • Aidinoff E.
      • Front L.
      • Itzkovich M.
      • et al.
      Expected Spinal Cord Independence Measure, Third Version, scores for various neurological level after complete spinal cord lesions.
      Floor and ceiling effects have been noted across all 3 subscales; these effects have been shown to vary according to patients' American Spinal Injury Association motor neurologic grade.
      • Ackerman P.
      • Morrison S.
      • McDowell S.
      • Vazquez L.
      Using the Spinal Cord Independence Measure III to measure functional recovery in a post-acute spinal cord injury program.
      The SCIM-III has been translated and validated in multiple languages,
      • Aguilar-Rodriguez M.
      • Pena-Paches L.
      • Grao-Castellote C.
      • Torralba-Collados F.
      • Hervas-Marin D.
      • Giner-Pascual M.
      Adaptation and validation of the Spanish self-report version of the Spinal Cord Independence Measure (SCIM III).
      • Wannapakhe J.
      • Saensook W.
      • Keawjoho C.
      • Amatachaya S.
      Reliability and discriminative ability of the Spinal Cord Independence Measure III (Thai version).
      • Unalan H.
      • Misirlioglu T.
      • Erhan B.
      • et al.
      Validity and reliability study of the Turkish version of Spinal Cord Independence Measure-III.
      • Invernizzi M.
      • Carda S.
      • Milani P.
      • et al.
      Development and validation of the Italian version of the Spinal Cord Independence Measure III.
      and self-report
      • Fekete C.
      • Eriks-Hoogland I.
      • Baumberger M.
      • et al.
      Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III).
      and youth
      • Mulcahey M.
      • Calhoun C.
      • Sinko R.
      • Kelly E.
      • Vogel L.
      The Spinal Cord Independence Measure (SCIM) - III self report for youth.
      versions have been developed.

      Authorship

      Measurement Characteristics and Clinical Utility of the Spinal Cord Independence Measure-III Among Individuals With Spinal Cord Injury was developed by Kristian P. Nitsch, MS, and Kelsey L. Stipp, MS.

      Disclaimer

      This Rehabilitation Measures Database summary provides a review of the psychometric properties of the SCIM-III in people with spinal cord injury, including reliability, validity, standard error of measurement, minimum detectable change, and interpretation of the results. A full review of the SCIM-III and reviews of >300 other instruments can be found at www.rehabmeasures.org. Correspondence can be addressed to [email protected] .
      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 the authors' employers, the instrument owner(s), Archives of Physical Medicine and Rehabilitation, the Rehabilitation Measures Database, or the U.S. 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, U.S. Department of Education through the Rehabilitation Research and Training Center on Improving Measurement of Medical Rehabilitation Outcomes (grant no. H133B090024).
      Figure thumbnail fx1

      References

        • Catz A.
        • Itzkovich M.
        • Agranov E.
        • Ring H.
        • Tamir A.
        SCIM - Spinal Cord Independence Measure: a new disability scale for patients with spinal cord lesions.
        Spinal Cord. 1997; 35: 850-856
        • Itzkovich M.
        • Gelernter I.
        • Biering-Sorensen F.
        • 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
        • Catz A.
        • Itzkovich M.
        • Tesio L.
        • et al.
        A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation.
        Spinal Cord. 2007; 45: 275-291
        • 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. 2011; 49: 880-885
        • Furlan J.
        • Noonan V.
        • Singh A.
        • Fehlings M.
        Assessment of disability in patients with acute traumatic spinal cord injury: a systematic review of the literature.
        J Neurotrauma. 2011; 28: 1413-1430
        • Anderson K.
        • Aito S.
        • Atkins M.
        • 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
        • Alexander M.
        • Anderson K.
        • Biering-Sorensen F.
        • et al.
        Outcome measures in spinal cord injury: recent assessments and recommendations for future directions.
        Spinal Cord. 2009; 47: 582-591
        • Bluvshtein V.
        • Front L.
        • Itzkovich M.
        • et al.
        SCIM III is reliable and valid in a separate analysis for traumatic spinal cord lesions.
        Spinal Cord. 2011; 49: 292-296
        • Scivoletto G.
        • Tamburella F.
        • Laurenza L.
        • Molinari M.
        The Spinal Cord Independence Measure: how much change is clinically significant for spinal cord injury subjects.
        Disabil Rehabil. 2013; 35: 1808-1813
        • Aidinoff E.
        • Front L.
        • Itzkovich M.
        • et al.
        Expected Spinal Cord Independence Measure, Third Version, scores for various neurological level after complete spinal cord lesions.
        Spinal Cord. 2011; 49: 893-896
        • Ackerman P.
        • Morrison S.
        • 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
        • Aguilar-Rodriguez M.
        • Pena-Paches L.
        • Grao-Castellote C.
        • Torralba-Collados F.
        • Hervas-Marin D.
        • Giner-Pascual M.
        Adaptation and validation of the Spanish self-report version of the Spinal Cord Independence Measure (SCIM III).
        Spinal Cord. 2015; 53: 451-454
        • Wannapakhe J.
        • Saensook W.
        • Keawjoho C.
        • Amatachaya S.
        Reliability and discriminative ability of the Spinal Cord Independence Measure III (Thai version).
        Spinal Cord. 2015 Jul 14; ([Epub ahead of print])
        • Unalan H.
        • Misirlioglu T.
        • Erhan B.
        • et al.
        Validity and reliability study of the Turkish version of Spinal Cord Independence Measure-III.
        Spinal Cord. 2015; 53: 455-460
        • Invernizzi M.
        • Carda S.
        • Milani P.
        • et al.
        Development and validation of the Italian version of the Spinal Cord Independence Measure III.
        Disabil Rehabil. 2010; 32: 1194-1203
        • Fekete C.
        • Eriks-Hoogland I.
        • Baumberger M.
        • et al.
        Development and validation of a self-report version of the Spinal Cord Independence Measure (SCIM III).
        Spinal Cord. 2013; 51: 40-47
        • Mulcahey M.
        • Calhoun C.
        • Sinko R.
        • Kelly E.
        • Vogel L.
        The Spinal Cord Independence Measure (SCIM) - III self report for youth.
        Spinal Cord. 2015 Jun 16; ([Epub ahead of print])