The spinal cord independence measure: how much change is clinically significant for spinal cord injury subjects.
OBJECTIVE
To calculate the clinical significance of the SCIM III according to distribution-based approaches.


METHODS
Retrospective review of the charts of 255 patients with registration of the total SCIM and of the four subscales. Clinical significance was calculated per several distribution-based approaches. The calculated clinical significance was compared with improvements by the patients to determine the percentage of patients who achieved significant improvement.


RESULTS
An improvement of at least 4 points of the total SCIM is needed to obtain a small significant improvement and of 10 points to obtain a substantial improvement. Based on these results, the percentages of patients who achieved an improvement varied from 60% to 100%.


CONCLUSIONS
The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress.


CONCLUSIONS
An improvement of at least four points of the total SCIM is needed to obtain a small significant improvement and of 10 points to obtain a substantial improvement. The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress.
Spinal Cord Unit, IRCCS Fondazione S. Lucia , Rome , Italy and.
Giorgio
G
Scivoletto
Federica
F
Tamburella
Letizia
L
Laurenza
Marco
M
Molinari
D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D002574:Cervical Vertebrae / Q000293:injuries; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007558:Italy; D008159:Lumbar Vertebrae / Q000293:injuries; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010264:Paraplegia / Q000175:diagnosis / Q000534:rehabilitation; D026741:Physical Therapy Modalities; D011782:Quadriplegia / Q000175:diagnosis / Q000534:rehabilitation; D020127:Recovery of Function; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D018570:Risk Assessment; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000534:rehabilitation*; D013904:Thoracic Vertebrae / Q000293:injuries; D016896:Treatment Outcome