The Spinal Cord Injury- Functional Index: Item Banks to Measure Physical Functioning of Individuals with Spinal Cord Injury

Arch Phys Med Rehabil, 2012 · DOI: 10.1016/j.apmr.2012.05.007 · Published: October 1, 2012

Spinal Cord Injury Participation Research Methodology & Design

Simple Explanation

This study focuses on creating a way to measure how well people with spinal cord injuries (SCI) can perform physical activities. The researchers wanted to know if physical function in SCI is best described as one general ability, two areas (like mobility and upper body), or several specific skills. They developed a list of questions (the SCI-FI) to assess different aspects of physical function and tested it with a large group of people with SCI.

Study Duration

Not specified

Participants

855 individuals with traumatic spinal cord injury

Evidence Level

Cross-sectional

Key Findings

1
A five-factor model of physical functioning (basic mobility, ambulation, wheelchair mobility, self-care, and fine motor skills) best describes the abilities of individuals with SCI.
2
Each of the five factors can be measured separately as a unidimensional construct.
3
The SCI-FI can be linked to other measures like PROMIS and Neuro-QOL allowing for comparison across different populations.

Research Summary

The study aimed to develop a comprehensive, patient-reported measure of physical functioning for individuals with SCI. The researchers created the Spinal Cord Injury – Functional Index (SCI-FI) through literature review, focus groups, and expert feedback. Confirmatory factor analysis supported a five-factor model of physical functioning: basic mobility, wheelchair mobility, ambulation, self-care, and fine motor skills.

Practical Implications

Comprehensive Assessment

The SCI-FI provides a more detailed and relevant assessment of physical functioning in SCI compared to general measures.

Cross-Condition Comparisons

Linking the SCI-FI to other measures enables comparisons of physical functioning across different populations and age groups.

Targeted Interventions

The five distinct item banks allow for targeted interventions and monitoring of specific areas of physical functioning.

Study Limitations

1
The study acknowledges the absence of clinical utility data for the five-factor structure, necessitating future research to evaluate its responsiveness and usefulness.
2
The large number of SCI-FI items (k = 328) made it impossible to evaluate the factor structure with structural equation modeling of all items in a single analysis.
3
Future research should also compare the results of clinician ratings of physical functioning performance with patient reported outcomes of physical functioning to determine the incremental validity of the SCI-FI.

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