title: Development and initial evaluation of the spinal cord injury-functional index.
abstract: OBJECTIVE
  To describe the calibration of the Spinal Cord Injury-Functional Index (SCI-FI) and report on the initial psychometric evaluation of the SCI-FI scales in each content domain.
  
  
  METHODS
  Cross-sectional survey followed by calibration data simulations.
  
  
  METHODS
  Inpatient and community settings.
  
  
  METHODS
  A sample of participants (N=855) with traumatic spinal cord injury (SCI) recruited from 6 SCI Model Systems and stratified by diagnosis, severity, and time since injury.
  
  
  METHODS
  None.
  
  
  METHODS
  SCI-FI instrument.
  
  
  RESULTS
  Item response theory analyses confirmed the unidimensionality of 5 SCI-FI scales: basic mobility (54 items), fine motor function (36 items), self-care (90 items), ambulation (39 items), and wheelchair mobility (56 items). All SCI-FI scales revealed strong psychometric properties. High correlations of scores on simulated computer adaptive testing (CAT) with the overall SCI-FI domain scores indicated excellent potential for CAT to accurately characterize functional profiles of adults with SCI. Overall, there was very little loss of measurement reliability or precision using CAT compared with the full item bank; however, there was some loss of reliability and precision at the lower and upper ranges of each scale, corresponding to regions where there were few questions in the item banks.
  
  
  CONCLUSIONS
  Initial evaluation revealed that the SCI-FI achieved considerable breadth of coverage in each content domain and demonstrated acceptable psychometric properties. The use of CAT to administer the SCI-FI will minimize assessment burden, while allowing for the comprehensive assessment of the functional abilities of adults with SCI.
authors.affiliation: Health and Disability Research Institute, Boston University School of Public Health, Boston, MA 02118, USA. ajette@bu.edu
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kisala
authors.forename: Mary D
authors.initials: MD
authors.lastname: Slavin
authors.forename: Marcel P
authors.initials: MP
authors.lastname: Dijkers
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Denise G
authors.initials: DG
authors.lastname: Tate
authors.forename: Gale
authors.initials: G
authors.lastname: Whiteneck
authors.forename: Susan
authors.initials: S
authors.lastname: Charlifue
authors.forename: Bethlyn
authors.initials: B
authors.lastname: Houlihan
authors.forename: Steve
authors.initials: S
authors.lastname: Williams
authors.forename: Steven
authors.initials: S
authors.lastname: Kirshblum
authors.forename: Trevor
authors.initials: T
authors.lastname: Dyson-Hudson
authors.forename: Jeanne
authors.initials: J
authors.lastname: Zanca
authors.forename: Denise
authors.initials: D
authors.lastname: Fyffe
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000465:Algorithms; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017063:Outcome Assessment, Health Care; D011594:Psychometrics; D011788:Quality of Life; D020127:Recovery of Function / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D014481:United States