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Reference Values and Cutoff Scores of the Spinal Cord Independence Measure III to Determine Independence for Wheelchair Users and Ambulatory Individuals With Spinal Cord Injury

  • Sugalya Amatachaya
    Correspondence
    Corresponding author Sugalya Amatachaya Dr, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Mitraphap Highway, Khon Kaen 40002, Thailand
    Affiliations
    School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand

    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
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  • Narongsak Khamnon
    Affiliations
    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand

    School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand
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  • Pattra Wattanapan
    Affiliations
    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand

    Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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  • Arpassanan Wiyanad
    Affiliations
    School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand

    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
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  • Thiwabhorn Thaweewannakij
    Affiliations
    School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand

    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
    Search for articles by this author
  • Wilairat Namwong
    Affiliations
    School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand

    Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
    Search for articles by this author
Published:October 09, 2022DOI:https://doi.org/10.1016/j.apmr.2022.09.016

      Abstract

      Objective

      To establish the reference values and optimal cutoff scores of the Spinal Cord Independence Measure Version III (SCIM III) to indicate independence of wheelchair users (WU) and ambulatory (AM) individuals with spinal cord injury (SCI).

      Design

      A cross-sectional study.

      Setting

      Tertiary rehabilitation center and communities.

      Participants

      A total of 309 (168 WU and 141 AM) participants with SCI.

      Interventions

      Not applicable.

      Main Outcome Measure(s)

      SCIM III scores.

      Results

      Participants with greater levels of independence had significantly higher SCIM III scores, both total and subitem scores (P<.05). The SCIM III scores of ≥55 and ≥75 were optimal indicators of modified independence in WU and AM individuals, respectively (sensitivity and specificity >93%, AUC>.95). In addition, scores of 90 were proved to be excellent indicators for independence of AM individuals (sensitivity 94%, specificity 100%, AUC=.99).

      Conclusions

      The present findings provide the reference values of SCIM III scores covering WU and AM individuals with SCI at various levels of independence as well as optimal cutoff scores to indicate independence of these individuals. These data can be used as standard criteria for data comparison with patients’ ability, and target functional values for individuals with SCI in clinical-, community-, and home-based settings.

      Keywords

      List of abbreviations:

      AIS (American Spinal Cord Injury Association Impairment Scale), AM (ambulatory), AUC (area under the ROC curve), ID (independence), ModASST (moderate to maximum assistance), MoID (modified independence), MiniASST (minimal assistance), ROC (receiver operating characteristic), SCI (spinal cord injury), SCIM III (Spinal Cord Independence Measure (version III)), TA (bedridden or total assistance), WU (wheelchair users)
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