title: Consumer preference in ranking walking function utilizing the walking index for spinal cord injury II.
abstract: METHODS
  Blinded rank ordering.
  
  
  OBJECTIVE
  To determine consumer preference in walking function utilizing the walking Index for spinal cord injury II (WISCI II) in individuals with spinal cord injury (SCI)from the Canada, the Italy and the United States of America.
  
  
  METHODS
  In all, 42 consumers with incomplete SCI (25 cervical, 12 thoracic, 5 lumbar) from Canada (12/42), Italy (14/42) and the United States of America (16/42) ranked the 20 levels of the WISCI II scale by their individual preference for walking. Subjects were blinded to the original ranking of the WISCI II scale by clinical scientists. Photographs of each WISCI II level used in a previous pilot study were randomly shuffled and rank ordered. Percentile, conjoint/cluster and graphic analyses were performed.
  
  
  RESULTS
  All three analyses illustrated consumer ranking followed a bimodal distribution. Ranking for two levels with physical assistance and two levels with a walker were bimodal with a difference of five to six ranks between consumer subgroups (quartile analysis). The larger cluster (N=20) showed preference for walking with assistance over the smaller cluster (N=12), whose preference was walking without assistance and more devices. In all, 64% (27/42) of consumers ranked WISCI II level with no devices or braces and 1 person assistance higher than multiple levels of the WISCI II requiring no assistance. These results were unexpected, as the hypothesis was that consumers would rank independent walking higher than walking with assistance.
  
  
  CONCLUSIONS
  Consumer preference for walking function should be considered in addition to objective measures in designing SCI trials that use significant improvement in walking function as an outcome measure.
authors.affiliation: Thomas Jefferson University, Regional SCI Center of the Delaware Valley, Department of Rehabilitation Medicine, Philadelphia, PA 19107, USA. Mary.Patrick@jefferson.edu
authors.forename: M
authors.initials: M
authors.lastname: Patrick
authors.forename: P
authors.initials: P
authors.lastname: Ditunno
authors.forename: J F
authors.initials: JF
authors.lastname: Ditunno
authors.forename: R J
authors.initials: RJ
authors.lastname: Marino
authors.forename: G
authors.initials: G
authors.lastname: Scivoletto
authors.forename: T
authors.initials: T
authors.lastname: Lam
authors.forename: J
authors.initials: J
authors.lastname: Loffree
authors.forename: F
authors.initials: F
authors.lastname: Tamburella
authors.forename: B
authors.initials: B
authors.lastname: Leiby
mesh_terms: D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D057240:Patient Preference; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D016138:Walking