A Catz1, M Itzkovich, E Agranov, H Ring, A Tamir. 1. Loewenstein Rehabilitation Hospital, Raanana and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Abstract
BACKGROUND: The spinal cord independence measure (SCIM) is a newly developed disability scale specific to patients with spinal cord lesions (SCL). Its sensitivity to functional changes in a whole cohort of SCL patients was found to be better than that of the functional independence measure (FIM). OBJECTIVE: o compare the sensitivity to functional changes of the SCIM and the FIM in SCL subgroups. DESIGN: A comparative self-controlled study. SETTING: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. SUBJECTS: 22 SCL inpatients. INTERVENTIONS: Monthly SCIM and FIM assessments of the subgroups. MAIN OUTCOME MEASURES: Functional change detection rate (FDR) and mean differences between consecutive scores (DCS). RESULTS: The outcome measures of the SCIM were higher than those of the FIM for tetraplegia and paraplegia, complete and incomplete lesions (the FIM missed 25-27% of the functional changes detected by the SCIM; DSC 8.2-11.4 vs 5.2-9; P<0.05 in most comparisons). The SCIM did not exhibit this advantage, however, in the functional areas of self-care and mobility in the room and toilet. Further subgrouping yielded similar results. CONCLUSIONS: The SCIM is more sensitive than the FIM to functional changes in the subgroups studied, and has the potential to serve as a universal tool for disability assessment of SCL patients.
BACKGROUND: The spinal cord independence measure (SCIM) is a newly developed disability scale specific to patients with spinal cord lesions (SCL). Its sensitivity to functional changes in a whole cohort of SCL patients was found to be better than that of the functional independence measure (FIM). OBJECTIVE: o compare the sensitivity to functional changes of the SCIM and the FIM in SCL subgroups. DESIGN: A comparative self-controlled study. SETTING: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. SUBJECTS: 22 SCL inpatients. INTERVENTIONS: Monthly SCIM and FIM assessments of the subgroups. MAIN OUTCOME MEASURES: Functional change detection rate (FDR) and mean differences between consecutive scores (DCS). RESULTS: The outcome measures of the SCIM were higher than those of the FIM for tetraplegia and paraplegia, complete and incomplete lesions (the FIM missed 25-27% of the functional changes detected by the SCIM; DSC 8.2-11.4 vs 5.2-9; P<0.05 in most comparisons). The SCIM did not exhibit this advantage, however, in the functional areas of self-care and mobility in the room and toilet. Further subgrouping yielded similar results. CONCLUSIONS: The SCIM is more sensitive than the FIM to functional changes in the subgroups studied, and has the potential to serve as a universal tool for disability assessment of SCL patients.
Authors: 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 Journal: J Spinal Cord Med Date: 2008 Impact factor: 1.985
Authors: Ross S Chafetz; John P Gaughan; Christina Calhoun; Jennifer Schottler; Lawrence C Vogel; Randal Betz; M J Mulcahey Journal: Top Spinal Cord Inj Rehabil Date: 2013