The spinal cord independence measure (SCIM): sensitivity to functional changes in subgroups of spinal cord lesion 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.


METHODS
A comparative self-controlled study.


METHODS
The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel.


METHODS
22 SCL inpatients.


METHODS
Monthly SCIM and FIM assessments of the subgroups.


METHODS
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.
Catz
A
A
Loewenstein Rehabilitation Hospital, Raanana and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Itzkovich
M
M
Agranov
E
E
Ring
H
H
Tamir
A
A
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D013118:Spinal Cord Diseases / Q000503:physiopathology*