title: Spinal cord injury-functional index: item banks to measure physical functioning in individuals with spinal cord injury.
abstract: OBJECTIVE
  To develop a comprehensive set of patient-reported items to assess multiple aspects of physical functioning relevant to the lives of people with spinal cord injury (SCI), and to evaluate the underlying structure of physical functioning.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Inpatient and community.
  
  
  METHODS
  Item pools of physical functioning were developed, refined, and field tested in a large sample of individuals (N=855) with traumatic SCI stratified by diagnosis, severity, and time since injury.
  
  
  METHODS
  None.
  
  
  METHODS
  Spinal Cord Injury-Functional Index (SCI-FI) measurement system.
  
  
  RESULTS
  Confirmatory factor analysis (CFA) indicated that a 5-factor model, including basic mobility, ambulation, wheelchair mobility, self-care, and fine motor function, had the best model fit and was most closely aligned conceptually with feedback received from individuals with SCI and SCI clinicians. When just the items making up basic mobility were tested in CFA, the fit statistics indicated strong support for a unidimensional model. Similar results were demonstrated for each of the other 4 factors, indicating unidimensional models.
  
  
  CONCLUSIONS
  Though unidimensional or 2-factor (mobility and upper extremity) models of physical functioning make up outcomes measures in the general population, the underlying structure of physical function in SCI is more complex. A 5-factor solution allows for comprehensive assessment of key domain areas of physical functioning. These results informed the structure and development of the SCI-FI measurement system of physical functioning.
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI 48109, USA. dtulsky@med.umich.edu
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kisala
authors.forename: Claire
authors.initials: C
authors.lastname: Kalpakjian
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.forename: Gale
authors.initials: G
authors.lastname: Whiteneck
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.forename: Steven
authors.initials: S
authors.lastname: Kirshblum
authors.forename: Susan
authors.initials: S
authors.lastname: Charlifue
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Martin
authors.initials: M
authors.lastname: Forchheimer
authors.forename: Mary D
authors.initials: MD
authors.lastname: Slavin
authors.forename: Bethlyn
authors.initials: B
authors.lastname: Houlihan
authors.forename: Denise G
authors.initials: DG
authors.lastname: Tate
authors.forename: Trevor
authors.initials: T
authors.lastname: Dyson-Hudson
authors.forename: Denise G
authors.initials: DG
authors.lastname: Fyffe
authors.forename: Steve
authors.initials: S
authors.lastname: Williams
authors.forename: Jeanne
authors.initials: J
authors.lastname: Zanca
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D014481:United States