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Sensitivity of the SCI-FI/AT in Individuals With Traumatic Spinal Cord Injury

Published:March 30, 2018DOI:https://doi.org/10.1016/j.apmr.2018.02.014

      Abstract

      Objective

      To examine the ability of the Spinal Cord Injury-Functional Index/Assistive Technology (SCI-FI/AT) measure to detect change in persons with spinal cord injury (SCI).

      Design

      Multisite longitudinal (12-mo follow-up) study.

      Setting

      Nine SCI Model Systems programs.

      Participants

      Adults (N=165) with SCI enrolled in the SCI Model Systems database.

      Interventions

      Not applicable.

      Main Outcome Measures

      SCI-FI/AT computerized adaptive test (CAT) (Basic Mobility, Self-Care, Fine Motor Function, Wheelchair Mobility, and/or Ambulation domains) completed at discharge from rehabilitation and 12 months after SCI. For each domain, effect size estimates and 95% confidence intervals were calculated for subgroups with paraplegia and tetraplegia.

      Results

      The demographic characteristics of the sample were as follows: 46% (n=76) individuals with paraplegia, 76% (n=125) male participants, 57% (n=94) used a manual wheelchair, 38% (n=63) used a power wheelchair, 30% (n=50) were ambulatory. For individuals with paraplegia, the Basic Mobility, Self-Care, and Ambulation domains of the SCI-FI/AT detected a significantly large amount of change; in contrast, the Fine Motor Function and Wheelchair Mobility domains detected only a small amount of change. For those with tetraplegia, the Basic Mobility, Fine Motor Function, and Self-Care domains detected a small amount of change whereas the Ambulation item domain detected a medium amount of change. The Wheelchair Mobility domain for people with tetraplegia was the only SCI-FI/AT domain that did not detect significant change.

      Conclusions

      SCI-FI/AT CAT item banks detected an increase in function from discharge to 12 months after SCI. The effect size estimates for the SCI-FI/AT CAT vary by domain and level of lesion. Findings support the use of the SCI-FI/AT CAT in the population with SCI and highlight the importance of multidimensional functional measures.

      Keywords

      List of abbreviations:

      ASIA (American Spinal Injury Association), AT (assistive technology), CAT (computerized adaptive test), ES (effect size), MDC90 (minimal detectable change at the 90% confidence level), SCI (spinal cord injury), SCI-FI/AT (Spinal Cord Injury-Functional Index/Assistive Technology), SCI-FI/C (Spinal Cord Injury-Functional Index/Capacity), SCIMS (Spinal Cord Injury Model Systems), SRFM (Self-Reported Functional Measure)
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