A structured review of outcome measures used for the assessment of rehabilitation interventions for spinal cord injury.
OBJECTIVE
To review the measurement properties of outcome measures of function or mobility currently used in the context of spinal cord injury (SCI).


METHODS
A keyword search of multiple databases to identify original papers. Papers were reviewed where they had included an evaluation, of people with SCI, of the psychometric properties of an outcome measure, which included functional or mobility domains.Information was extracted concerning item generation, ease and intended method of use and scale properties, in particular: reliability, validity and responsiveness. Conclusions were reached concerning the psychometric properties of each instrument.


RESULTS
Eight outcome measures were identified (plus adapted versions). Five had originally been developed specifically for evaluating patients with SCI (chiefly reflecting clinicians' perspectives), the remaining three had not. The psychometric properties of the instruments varied, with some mixed/contradictory evidence likely relating to differing study sample sizes, characteristics and variable quality. Instruments also varied in stated purpose or emphasis.


CONCLUSIONS
In addition to weighing evidence concerning measurement properties, users need to consider the stated purpose and item content of instruments in relation to their specific aims. With regard to the former, while reviewed instruments had some flaws, the Spinal cord Independence Measure (revised version III), Quadriplegia Index of Function (Short-form), Needs Assessment Checklist and SIP68 appeared the best, despite limited evidence of their responsiveness.
Department of Public Health, University of Oxford, Oxford, UK. jill.dawson@dphpc.ox.ac.uk
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Dawson
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Shamley
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Jamous
D004185:Disability Evaluation; D006040:Goals; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards / Q000639:trends; D010243:Paralysis / Q000175:diagnosis* / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000592:standards / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011594:Psychometrics / Q000379:methods / Q000592:standards / Q000639:trends; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*