Functional Recovery Measures for Spinal Cord Injury: An Evidence-Based Review for Clinical Practice and Research

J Spinal Cord Med, 2008 · DOI: · Published: January 1, 2008

Spinal Cord Injury Participation Research Methodology & Design

Simple Explanation

This study evaluates different ways to measure how well people with spinal cord injuries (SCI) can do everyday tasks. The main goal is to find the best tool to track functional recovery, which is different from just seeing if nerves are healing. A group of experts from different countries looked at four measurement tools to see which ones are reliable and useful for SCI patients.

Study Duration

Not specified

Participants

Multinational work group

Evidence Level

Review

Key Findings

1
The Modified Barthel Index (MBI) has minimal evidence for validity and little clinical utility for use in the SCI population.
2
The Functional Independence Measure (FIM) primarily measures the burden of care and may not accurately reflect functional recovery in SCI.
3
The Spinal Cord Independence Measure (SCIM) is specifically designed for SCI and is recommended as the primary functional recovery outcome measure.

Research Summary

This review evaluated functional outcome measures for spinal cord injury (SCI) to determine their utility in clinical practice and research. The work group recommends that the latest version of the SCIM (SCIM III) continue to be refined and validated and subsequently implemented worldwide. The QIF may continue to be developed and validated for use as a supplemental tool for the nonambulatory tetraplegic population.

Practical Implications

Standardized Assessment

The SCIM III should be used as the primary outcome measure for assessing functional recovery in SCI.

Targeted Interventions

The QIF can be used as a supplemental tool for evaluating nonambulatory tetraplegic individuals, particularly in assessing fine hand functions.

Improved Clinical Trials

Using the SCIM III in clinical trials can improve the ability to detect, measure, and predict functional recovery in the SCI population.

Study Limitations

1
The scoring system may be inappropriate for assessing outcome measures designed for specific subpopulations of SCI.
2
Further validation and reliability studies are needed for the QIF.
3
The SCIM is insensitive to changes or differences in walking speed.

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