title: The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse.
abstract: METHODS
  Literature review.
  
  
  OBJECTIVE
  To critically review all publications/internet sites that have described/used the Walking Index for Spinal Cord Injury (WISCI II), as a measure of impairment of walking function after spinal cord injury (SCI), in order to identify its psychometric properties, clarify its nature, specify misuse and incorporate the findings in an updated guide.
  
  
  METHODS
  A systematic literature search was done of Ovid MEDLINE, CINAHL, PsychINFO, Cochrane Central Register of Controlled Trials, Scopus and electronic sites using key words: WISCI or WISCI II, SCI, paraplegia/ tetraplegia/ quadriplegia and ambulation/gait/walking. Among 1235 citations retrieved, 154 relevant articles/sites were identified, classified and examined by the authors; recommendations were made based on findings.
  
  
  CONCLUSIONS
  The validity (face/concurrent/content/construct/convergent/criterion) and reliability of the WISCI II has been documented in clinical trials and clinical series, and considered adequate by systematic reviewers. In chronic SCI subjects, reliable determination of the maximum (as opposed to self-selected) WISCI II level requires more time and experience by the assessor. The correct use of WISCI II is clarified for testing acute/chronic phases of recovery after SCI, age of subjects, devices and settings. The WISCI II and walking speed measures may be performed simultaneously.
  
  
  CONCLUSIONS
  The increased use of the WISCI II is attributed to its unique characteristics as a capacity measure of walking function and its strong metric properties. Appropriate use of the WISCI II was clarified and incorporated into a new guide for its use. Combining it with a walking speed measure needs further study.
authors: Regional Spinal Cord Injury Center of the Delaware Valley, Thomas Jefferson University/Magee Rehabilitation, Philadelphia, PA 19107, USA. John.Ditunno@jefferson.edu
authors: J F
authors: JF
authors: Ditunno
authors: P L
authors: PL
authors: Ditunno
authors: G
authors: G
authors: Scivoletto
authors: M
authors: M
authors: Patrick
authors: M
authors: M
authors: Dijkers
authors: H
authors: H
authors: Barbeau
authors: A S
authors: AS
authors: Burns
authors: R J
authors: RJ
authors: Marino
authors: M
authors: M
authors: Schmidt-Read
mesh_terms: D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D020127:Recovery of Function; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000150:complications*; D016138:Walking