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Validation of the Spinal Cord Injury–Functional Index for Use in Community-Dwelling Individuals With SCI

Published:January 12, 2021DOI:https://doi.org/10.1016/j.apmr.2020.12.009

      Abstract

      Objective

      To evaluate the psychometric properties of the Spinal Cord Injury–Functional Index (SCI-FI) instruments in a community-dwelling sample.

      Design

      Cross-sectional study.

      Setting

      Community setting.

      Participants

      Individuals (N=269) recruited from 6 SCI Model Systems sites.

      Interventions

      Not applicable.

      Main Outcome Measures

      Participants completed computer adaptive test and short form versions of 4 SCI-FI/Capacity (C) banks (ie, Ambulation, Basic Mobility, Fine Motor, Self-Care) and 1 SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after 2 weeks. The Self-Report Functional Measure (SRFM) and the clinician-rated motor FIM were used to evaluate evidence of convergent validity.

      Results

      Pearson correlations, intraclass correlation coefficients, minimal detectable change, and Bland-Altman plots supported the test-retest reliability of the SCI-FI instruments. Correlations were large with the SRFM (.69-.89) and moderate-to-large for the FIM instrument (.44-.64), supporting convergent validity. Known-groups validity was demonstrated by a significant main effect of injury level on all instruments and a main effect of injury completeness on the SCI-FI/C instruments. A ceiling effect was detected for individuals with incomplete paraplegia on the Fine Motor/C and Self-Care/C Short Forms.

      Conclusion

      Findings support the test-retest reliability, convergent validity, and known-groups validity of the SCI-FI/C instruments and the SCI-FI/AT Wheelchair Mobility instruments for use by community-dwelling individuals.

      Keywords

      List of abbreviations:

      AT (assistive technology), CAT (computer adaptive test), ICC (intraclass correlation coefficient), IRT (item response theory), MDC (minimal detectable change), NIH (National Institutes of Health), QOL (quality of life), SCI (spinal cord injury), SCI-FI (Spinal Cord Injury–Functional Index), SCI-FI/AT (Spinal Cord Injury–Functional Index/Assistive Technology), SCI-FI/C (Spinal Cord Injury–Functional Index/Capacity), SEM (standard error of measurement), SRFM (Self-Report Functional Measure)
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