Abstract
Objectives
Seated balance (SB) is substantially compromised and greatly impacts the function
of individuals living with a spinal cord injury (SCI). A clinically applicable criterion
standard measure for SB does not exist for this population. Initial validation and
reliability analysis of the Function in Sitting Test (FIST) in SCI has been published,
but the authors of this study report that modifications to the tool may be necessary.
This study aimed to explore the psychometrics and clinical utility of a modified version
of the FIST to better measure SCI-specific functional tasks in sitting.
Design
The FIST was modified (FIST-SCI) by an expert panel and used by 2 graders to evaluate
the SB of individuals with chronic SCI (cSCI) on 2 separate days. The Motor Assessment
Scale item 3 (MAS-SCI) was included as a comparison measure.
Setting
Research facility.
Participants
Individuals with cSCI longer than 1 year (N=38) participated in the study. Injury
levels of individuals participating in this study spanned C1 to T10 (American Spinal
Injury Association Impairment Scale A, 17 subjects; B, 12 subjects; and C, 9 subjects).
Thirteen individuals required assistance to transfer.
Interventions
Not applicable.
Main Outcome Measures
Validity, reliability, internal consistency, sensitivity, specificity, and responsiveness.
Results
Validity testing found a moderate relationship between the MAS-SCI and the FIST-SCI
(ρ, .522; P<.05). FIST-SCI scores distinguished individuals requiring assistance to transfer
from those who were independent (t=4.51; P<.05). Inter- and intra-rater reliability were excellent (intraclass correlation coefficient
(2,k)=.985 and .983, respectively) and internal consistency was excellent (α=.94). A FIST-SCI
cutoff score of 45 or greater was 92% sensitive and specific in characterizing transfer
ability. Standard error of the measure (1.3) and minimal detectable change (3.5) were
similar to previous work.
Conclusions
Initial validity of the FIST-SCI is reported, but further assessment is required.
Reliability is excellent in the cSCI population. FIST-SCI scores provide clinical
insight into the seated functional ability of individuals with cSCI.
Keywords
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), AT (assisted transfer), Cα (Cronbach’s alpha), CI (confidence interval), FIST (Function in Sitting Test), FIST-SCI (SCI version of the FIST), FSB (functional sitting balance), IC (internal consistency), ICC (intraclass correlational coefficient), IT (independent transfer), KGV (known-groups validity), LOI (level of injury), MAS-SCI (Motor Assessment Scale item 3), MDC (minimal detectable change), OM (outcome measure), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 13, 2020
Footnotes
Supported by the University of Miami School of Medicine Department of Physical Therapy, The Craig H. Neilsen Foundation Allied Health Professional Award of ASIA (GR012004), and the Foundation for Physical Therapy Research Promotion of Doctoral Studies Scholarship I.
Disclosures: Anne E. Palermo received funding from the Craig H. Neilsen Foundation and the Foundation for Physical Therapy Research. The other authors have nothing to disclose.
Identification
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© 2020 by the American Congress of Rehabilitation Medicine
