title: Evaluation of the Walking Index for Spinal Cord Injury II (WISCI-II) in children with Spinal Cord Injury (SCI).
abstract: METHODS
  Mixed methods were used in this study. The appropriateness of the levels of the Walking Index for Spinal Cord Injury II (WISCI-II) for application in children was critically reviewed by physical therapists using the Modified Delphi Technique, and the inter- and intra-rater reliability of the WISCI-II in children was evaluated.
  
  
  OBJECTIVE
  To examine the construct validity, and to establish reliability of the WISCI-II related to its use in children with spinal cord injury (SCI).
  
  
  METHODS
  United States of America.
  
  
  METHODS
  Using a Modified Delphi Technique, physical therapists critically reviewed the WISCI-II levels for pediatric utilization. Concurrently, ambulatory children under age 18 years with SCI were evaluated using the WISCI-II on two occasions by the same therapist to establish intra-rater reliability. One trial was photographed and de-identified. Each photograph was reviewed by four different physical therapists who gave WISCI-II scores to establish inter-rater reliability. Summary and descriptive statistics were used to calculate the frequency of yes/no responses for each WISCI-II level question and to determine the percent agreement for each question. Inter- and intra-rater reliability was calculated using interclass correlation coefficients (ICCs) with 95% confidence intervals (CI).
  
  
  RESULTS
  Construct validity was confirmed after one Delphi round during which at least 80% agreement was established by 51 physical therapists on the appropriateness of the WISCI-II levels for children. Fifty-two children with SCI aged 2-17 years completed repeated WISCI-II assessments and 40 de-identified photographs were scored by four physical therapists. Intra- and inter-rater reliability was high (ICC=0.997, CI=0.995-0.998 and ICC=0.97, CI=0.95-0.98, respectively).
  
  
  CONCLUSIONS
  This study demonstrates support for the use of the WISCI-II in ambulatory children with SCI.
  
  
  BACKGROUND
  This study was funded by the Craig H Neilsen Foundation, Spinal Cord Injury Research on the Translation Spectrum, Senior Research Award #282592 (Mulcahey, PI).
authors.affiliation: Department of Occupational Therapy, Jefferson College of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: C
authors.initials: C
authors.lastname: Calhoun Thielen
authors.affiliation: International Center for Spinal Cord Injury, Kennedy Krieger Institute, Baltimore, MD, USA.
authors.forename: C
authors.initials: C
authors.lastname: Sadowsky
authors.affiliation: Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Vogel
authors.affiliation: TIRR Memorial Hermann, Houston, TX, USA.
authors.forename: H
authors.initials: H
authors.lastname: Taylor
authors.affiliation: Shriners Hospitals for Children, Sacramento, CA, USA.
authors.forename: L
authors.initials: L
authors.lastname: Davidson
authors.affiliation: Mary Freebed Rehabilitation Hospital, Grand Rapids, MI, USA.
authors.forename: J
authors.initials: J
authors.lastname: Bultman
authors.affiliation: Department of Occupational Therapy, Jefferson College of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: J
authors.initials: J
authors.lastname: Gaughan
authors.affiliation: Department of Occupational Therapy, Jefferson College of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Mulcahey
mesh_terms: D002648:Child; D004185:Disability Evaluation; D005260:Female; D020233:Gait Disorders, Neurologic / Q000628:therapy*; D006801:Humans; D008297:Male; D059825:Physical Therapists; D020127:Recovery of Function / Q000502:physiology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000175:diagnosis* / Q000628:therapy*; D016138:Walking / Q000502:physiology