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)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: March 30, 2018
Footnotes
Supported in part by grants funding the Spinal Cord Injury Model System (grant nos. 90SI5015-01-00, 90SI5026, 90SI5012, 90SI5009, 90S15014, 90S15000, and 90S15021-01-00), sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services, and by a Promotion of Doctoral Studies (PODS) I Scholarship from the Foundation for Physical Therapy.
Disclosures: R. Zafonte serves on the scientific advisory board of Myomo, ElMIndA, and Oxeia Biopharmaceuticals; he has also received book and educational royalties from Demos and Oakstone. D. Tulsky shares copyright of the Spinal Cord Injury-Functional Index version 1.0 with Kessler Foundation and Boston University. The other authors have nothing to disclose.
Identification
Copyright
© 2018 by the American Congress of Rehabilitation Medicine
