Developing a contemporary functional outcome measure for spinal cord injury research.
METHODS
This study used qualitative analysis of focus group discussions.


OBJECTIVE
The primary objective was to select functional activities to include in an item pool, which is the first step in developing a spinal cord injury computer adaptive test (SCI-CAT).


METHODS
This multisite study was conducted at six US National Spinal Cord Injury Model Systems Programs.


METHODS
Focus group discussions, which included persons with tetraplegia and paraplegia and clinicians, were conducted. Transcripts were analyzed using a grounded theory approach. Functional activities were identified, binned, winnowed, written as functional items, and cognitively tested.


RESULTS
Focus group discussion analysis identified 326 functional activity items that fit into categories outlined in the International Classification of Functioning, Disability and Health (ICF) framework: Mobility (193 items), including assessment of functioning in a manual (44 items) and power wheelchair (19 items); self-care (109 items); and communication (19 items). Items related to sexual function were also identified (5 items).


CONCLUSIONS
The SCI-CAT item pool includes items that assess functional activities important to persons with SCI. Items cover a wide range of functional ability and reflect most ICF categories. The SCI-CAT pool is currently being field tested to develop a calibrated item bank. Further development will yield a CAT of functional activities appropriate for SCI research.
Health and Disability Research Institute, Boston University School of Public Health, Boston, MA 02118, USA. mslavin@bu.edu
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Slavin
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Kisala
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Jette
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Tulsky
D000203:Activities of Daily Living; D000328:Adult; D017281:Cost of Illness; D003446:Crutches; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009048:Motor Skills; D009068:Movement / Q000502:physiology; D010264:Paraplegia / Q000175:diagnosis / Q000534:rehabilitation; D011782:Quadriplegia / Q000175:diagnosis / Q000534:rehabilitation; D020127:Recovery of Function / Q000502:physiology*; D012015:Reference Standards; D012648:Self Care; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000175:diagnosis* / Q000534:rehabilitation*; D016896:Treatment Outcome; D014853:Walkers; D016138:Walking / Q000502:physiology; D014910:Wheelchairs