Abstract
Objective
To examine the fourth version of the Spinal Cord Independence Measure for reliability
and validity.
Design
Partly blinded comparison with the criterion standard Spinal Cord Independence Measure
III, and between examiners and examinations.
Setting
A multicultural cohort from 19 spinal cord injury units in 11 countries.
Participants
A total of 648 patients with spinal cord injury.
Intervention
Assessment with Spinal Cord Independence Measure (SCIM IV) and Spinal Cord Independence
Measure (SCIM III) on admission to inpatient rehabilitation and before discharge.
Main outcome measures
SCIM IV interrater reliability, internal consistency, correlation with and difference
from SCIM III, and responsiveness.
Results
Total agreement between examiners was above 80% on most SCIM IV tasks. All Kappa coefficients
were above 0.70 and statistically significant (P<.001). Pearson's coefficients of the correlation between the examiners were above
0.90, and intraclass correlation coefficients were above 0.90. Cronbach's alpha was
above 0.96 for the entire SCIM IV, above 0.66 for the subscales, and usually decreased
when an item was eliminated. Reliability values were lower for the subscale of respiration
and sphincter management, and on admission than at discharge. SCIM IV and SCIM III
mean values were very close, and the coefficients of Pearson correlation between them
were 0.91-0.96 (P<.001). The responsiveness of SCIM IV was not significantly different from that of
SCIM III in most of the comparisons.
Conclusions
The validity, reliability, and responsiveness of SCIM IV, which was adjusted to assess
specific patient conditions or situations that SCIM III does not address, and which
includes more accurate definitions of certain scoring criteria, are very good and
quite similar to those of SCIM III. SCIM IV can be used for clinical and research
trials, including international multi-center studies, and its group scores can be
compared with those of SCIM III.
Keywords
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Article info
Publication history
Published online: October 19, 2021
Accepted:
July 27,
2021
Received in revised form:
July 21,
2021
Received:
June 12,
2021
Footnotes
List of Abbreviations: ICC, intraclass correlation coefficient; LOS, Length Of Stay in rehabilitation; NIDRR, National Institute on Disability and Rehabilitation Research; SCI, spinal cord injury; SCIM, Spinal Cord Independence Measure.
Disclosures: none.
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
