Measuring Activity Limitation Outcomes in Youth with Spinal Cord Injury

Spinal Cord, 2016 · DOI: 10.1038/sc.2015.194 · Published: July 1, 2016

Spinal Cord Injury Pediatrics Rehabilitation

Simple Explanation

The Pediatric Spinal Cord Injury Activity Measure (PEDI-SCI AM) is designed to assess activity outcomes in youth with SCI. It includes different domains such as General Mobility, Daily Routines, Wheeled Mobility, and Ambulation. The PEDI-SCI AM can be administered in two ways: computerized adaptive tests (CATs) or short forms (SFs). CATs use a computer program to select items based on the individual's responses, while SFs are static sets of items. The study examined the psychometric properties of the PEDI-SCI AM item banks, CATs, and SFs. This involved assessing their reliability, consistency, and agreement to ensure they accurately measure activity limitations in youth with SCI.

Study Duration

Not specified

Participants

381 children and adolescents with SCI and 322 parents or caregivers

Evidence Level

Cross-sectional

Key Findings

1
The PEDI-SCI AM item banks, 10-item CATs and SFs demonstrate acceptable group reliability (0.73-0.96) and internal consistency (0.77-0.98).
2
ICC values show strong agreement with item banks for 10-item CATs (0.72-0.99) and SFs.
3
Ceiling effects are minimal for children with tetraplegia, but high in children with paraplegia for General Mobility (13.41-26.05%) and Daily Activities (12.99-32.71%).

Research Summary

The PEDI-SCI AM is a new measure developed specifically for youth with SCI to assess activity limitation outcomes. It includes calibrated item banks for General Mobility, Daily Routines, Wheeled Mobility and Ambulation. The study examined the psychometric properties of the PEDI-SCI AM item banks, CATs, and SFs. Results showed acceptable reliability and internal consistency for all versions. The PEDI-SCI AM exhibited strong psychometric properties for children with tetraplegia, but replenishment of the General Mobility and Daily Routines item banks is needed to reduce ceiling effects noted for youth with paraplegia.

Practical Implications

Clinical Assessment

The PEDI-SCI AM provides clinicians with a relevant and efficient tool to assess activity limitations in youth with SCI, aiding in the development of targeted rehabilitation programs.

Research Tool

The PEDI-SCI AM can be used in research to examine the efficacy of rehabilitation programs and support evidence-based practice in pediatric SCI.

Tracking Function

The PEDI-SCI AM, linked to the Spinal Cord Injury-Functional Index (SCI-FI), allows for tracking of function across the lifespan, providing a comprehensive view of patient outcomes.

Study Limitations

1
The sample, drawn from three Shriners Hospitals for Children in the United States, may not be representative.
2
The sample is relatively small, but acceptable given the overall number of children with SCI.
3
Ceiling effects were noted for Daily Routines in children with paraplegia; ceiling effects are unacceptable.

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