Validation of the Spinal Cord Injury Functional Index (SCI-FI) for use in community dwelling individuals with SCI

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

      269 individuals recruited from six SCI Model Systems sites.

      Interventions

      n/a

      Main Outcome Measures

      Participants completed computer adaptive test (CAT) and short form versions of four SCI-FI/Capacity banks (SCI-FI/C; Ambulation, Basic Mobility, Fine Motor, Self-Care) and one SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after two weeks. The Self Report Functional Measure (SRFM) and the clinician-rated motor Functional Independence Measure (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

      Abbreviations:

      ANOVA ( analysis of variance), AT ( assistive technology), CAT ( computer adaptive test), FIM ( Functional Independence Measure), HRQOL ( health-related quality of life), ICF ( International Classification of Functioning, Disability, and Health), IRT ( item response theory), Neuro-QoL ( Quality of Life in Neurological Disorders), NIH ( National Institute of Health), PROMIS® ( Patient Reported Outcomes Measurement Information System), 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), SCI-QOL ( Spinal Cord Injury Quality of Life Measurement System), SRFM ( Self-Report Functional Measure)
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