Validation of the Spinal Cord Injury-Functional Index for Use in Community-Dwelling Individuals With SCI

Callie E Tyner; Pamela A Kisala; Allen W Heinemann; Denise Fyffe; Denise G Tate; Mary D Slavin; Alan M Jette; David S Tulsky

doi:10.1016/j.apmr.2020.12.009

Validation of the Spinal Cord Injury-Functional Index for Use in Community-Dwelling Individuals With SCI

Arch Phys Med Rehabil. 2022 Feb;103(2):191-198. doi: 10.1016/j.apmr.2020.12.009. Epub 2021 Jan 13.

Authors

Callie E Tyner¹, Pamela A Kisala², Allen W Heinemann³, Denise Fyffe⁴, Denise G Tate⁵, Mary D Slavin⁶, Alan M Jette⁶, David S Tulsky⁷

Affiliations

¹ Center for Health Assessment Research and Translation, University of Delaware, Newark, DE. Electronic address: ctyner@udel.edu.
² Center for Health Assessment Research and Translation, University of Delaware, Newark, DE.
³ Shirley Ryan AbilityLab, Chicago, IL; Feinberg School of Medicine, Northwestern University, Chicago, IL.
⁴ Kessler Foundation, West Orange, NJ; New Jersey Medical School, Newark, NJ.
⁵ Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI.
⁶ Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA; Massachusetts General Hospital, Institute of Health Professions, Boston, MA.
⁷ Center for Health Assessment Research and Translation, University of Delaware, Newark, DE; Department of Physical Therapy, University of Delaware, Newark, DE; Department of Psychological and Brain Sciences, University of Delaware, Newark, DE.

PMID: 33453193
DOI: 10.1016/j.apmr.2020.12.009

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: Individuals (N=269) recruited from 6 SCI Model Systems sites.

Interventions: Not applicable.

Main outcome measures: Participants completed computer adaptive test and short form versions of 4 SCI-FI/Capacity (C) banks (ie, Ambulation, Basic Mobility, Fine Motor, Self-Care) and 1 SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after 2 weeks. The Self-Report Functional Measure (SRFM) and the clinician-rated motor 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: Patient-reported outcome measures; Psychometrics; Quality of life; Rehabilitation; Spinal cord injuries.

Publication types

Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Activities of Daily Living
Cross-Sectional Studies
Disability Evaluation
Humans
Independent Living*
Reproducibility of Results
Spinal Cord Injuries*