Abstract
Objective
To establish responsiveness of 3 Spinal Cord Injury–Functional Index/Capacity (SCI-FI/C)
item banks in the first year after spinal cord injury (SCI).
Design
Longitudinal patient-reported outcomes assessment replicated through secondary analysis
of an independent data set.
Setting
A total of 8 SCI Model Systems rehabilitation hospitals in the United States.
Participants
Study 1 participants included 184 adults with recent (≤4 months) traumatic SCI and
221 community-dwelling adults (>1 year post injury) (N=405). Study 2 participants
were 418 individuals with recent SCI (≤4 months) (N=418).
Interventions
In study 1, SCI-FI/C computer adaptive tests were presented in a standardized interview
format either in person or by phone call at baseline and 6-month follow-up. Responsiveness
was examined by comparing 6-month changes in SCI-FI scores within and across samples
(recently injured vs community-dwelling) because only the recent injury sample was
expected to exhibit change over time. Effect sizes were also computed. In study 2,
the study 1 results were cross-validated in a second sample with recent SCI 1 year
after baseline measurement. Study 2 also compared the SCI-FI/C measures’ responsiveness
to that of the Self-reported Functional Measure (SRFM) and stratified results by injury
diagnosis and completeness.
Main Outcome Measures
The SCI-FI Basic Mobility/C, Self-care/C and Fine Motor/C item banks (study 1 and
study 2); Self-reported Functional Measure SRFM (study 2 only).
Results
In study 1, changes in SCI-FI/C scores between baseline and 6-month follow-up were
statistically significant (P<.01) for recently injured individuals. SCI-FI Basic Mobility/C, Self-care/C, and
Fine Motor/C item banks demonstrated small to medium effect sizes in the recently
injured sample. In the community-dwelling sample, all SCI-FI/C effects were negligible
(ie, effect size<0.08). Study 2 results were similar to study 1. As expected, SCI-FI
Basic Mobility/C and Self-care/C were responsive to change for all individuals in
study 2, whereas the SCI-FI Fine Motor/C was responsive only for individuals with
tetraplegia and incomplete paraplegia. The SRFM demonstrated a medium effect size
for responsiveness (effect size=0.65).
Conclusions
The SCI-FI Basic Mobility/C and Self-care/C banks demonstrate adequate sensitivity
to change at 6 months and 1 year for all individuals with SCI, while the SCI-FI/C
Fine Motor item bank is sensitive to change in individuals with tetraplegia or incomplete
paraplegia. All SCI-FI/C banks demonstrate stability in a sample not expected to change.
Results provide support for the use of these measures for research or clinical use.
Keywords
List of abbreviations:
ANCOVA (analysis of covariance), AT (assistive technology), C (capacity), CAT (computer adaptive test), SCI (spinal cord injury), SCI-FI (Spinal Cord Injury–Functional Index), QOL (quality of life), 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: October 27, 2021
Accepted:
October 1,
2021
Received in revised form:
September 21,
2021
Received:
January 18,
2018
Footnotes
Supported by grant no. 5R01HD054569 from the National Institutes of Health––National Center on Medical Rehabilitation Research and the National Institute on Neurological Disorders and Stroke and by grant nos. H133N110002, H133N110007, H133N110006, H133N110020, H133N110019, H133N110014, H133N110005, and H133N110003 from the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR). Additional analyses and manuscript preparation were supported by grant no. G2015-26 from the Rick Hansen Institute (PI: Kisala) and by a Psychosocial Research Postdoctoral Fellowship Grant from the Craig H. Neilsen Foundation (no. 364962; PI: Cohen). We acknowledge an Institutional Development Award (IDeA) from the National Institute of General Medical Sciences of the National Institutes of Health under grant no. U54-GM104941 (PI: Binder-Macleod), which provided salary support for Dr Cohen.
Disclosures: none
Identification
Copyright
© 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
