Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions

Abstract

Purpose: To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury.

Method: The cross-sectional study included 30 patients (66% females; 41.5 ± 14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0–100 points) and FIM™ (18–126 points) by two raters (A and B) at the same day and 1 week later (A).

Results: The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC = 0.9). Correlation between the SCIM III and the motor FIM™ was appropriate (r = 0.6; p = 0.0). SCIM III subscales and FIM™ domains correlated strongly for self-care (r = 0.8; p ≤ 0.001), moderately for transfers (r = 0.6; p = 0.0005) and locomotion (r = 0.6; p = 0.0006). SCIM III mobility subscale positively correlated with the cadence (r = 0.8; p ≤ 0.01), gait speed (r = 0.7; p ≤ 0.01) and step length (r = 0.6; p ≤ 0.01).

Conclusions: SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale.

Implications for Rehabilitation

• Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions.

• There are not many studies focused on patients with non-traumatic spinal cord lesion.

• Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation.

• We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.

Keywords:

• Applicability of tests
• functioning
• non-traumatic spinal cord injury
• reproducibility of tests
• spastic paraparesis
• Spinal Cord Independence Measure version III
• validity of tests

Acknowlegments

The authors sincerely thank all the support from Prof Oswaldo Massaiti Takayanagui, MD, PhD and Charles Marques Lourenûïo, MD, PhD for the support and clinical care for all the subjects in the study.

Declaration of interest

The authors report no conflict of interest.