Functional recovery measures for spinal cord injury: an evidence-based review for clinical practice and research
Kim Anderson, Sergio Aito, Michal Atkins, Fin Biering-Sørensen, Susan Charlifue, Armin Curt, John Ditunno, Clive Glass, Ralph Marino, Ruth Marshall, Mary Jane Mulcahey, Marcel Post, Gordana Savic, Giorgio Scivoletto, Amiram Catz, Functional Recovery Outcome Measures Work Group, Kim Anderson, Sergio Aito, Michal Atkins, Fin Biering-Sørensen, Susan Charlifue, Armin Curt, John Ditunno, Clive Glass, Ralph Marino, Ruth Marshall, Mary Jane Mulcahey, Marcel Post, Gordana Savic, Giorgio Scivoletto, Amiram Catz, Functional Recovery Outcome Measures Work Group
Abstract
Background/objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome measures designed to assess functional status relevant to SCI are important to develop.
Method: Evaluation of currently available SCI functional outcome measures by a multinational work group.
Results: The 4 measures that fit the prespecified inclusion criteria were the Modified Barthel Index (MBI), the Functional Independence Measure (FIM), the Quadriplegia Index of Function (QIF), and the Spinal Cord Independence Measure (SCIM). The MBI and the QIF were found to have minimal evidence for validity, whereas the FIM and the SCIM were found to be reliable and valid. The MBI has little clinical utility for use in the SCI population. Likewise, the FIM applies mainly when measuring burden of care, which is not necessarily a reflection of functional recovery. The QIF is useful for measuring functional recovery but only in a subpopulation of people with SCI, and substantial validity data are still required. The SCIM is the only functional recovery outcome measure designed specifically for SCI.
Conclusions: The multinational work group recommends that the latest version of the SCIM (SCIM III) continue to be refined and validated and subsequently implemented worldwide as the primary functional recovery outcome measure for SCI. The QIF may continue to be developed and validated for use as a supplemental tool for the nonambulatory tetraplegic population.
Conflict of interest statement
The views expressed in this article are the result of independent research and do not necessarily represent the views of the US Department of Education. The SCI Measures Meeting was supported by grant funds from the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitation Services in the US Department of Education.
Source: PubMed