Validity and responsiveness of the spinal cord index of function: An instrument on activity level
Abstract written by: Theresa Vidalon, MSW
Johansson, C., Bodin, P., & Kreuter, M. (2009). Validity and responsiveness of the spinal cord index of function: An instrument on activity level. Spinal Cord, 47, 817-821.
The ability of a person with a spinal cord lesion (SCL) to carry out the activities of daily living is positively associated with physical and mental health, as well as predictive of independent living. Furthermore, when persons with a SCL are able to improve their ability to perform various transfers (i.e., transferring from a bed to a wheelchair), their independence is enhanced. This study assesses the validity and responsiveness of the Spinal Cord Index of Function, which is a new instrument designed to measure the capacity of a person with SCL to perform various transfers as instructed by a physiotherapist.
A total of 29 participants with spinal cord lesions were recruited from Sahlgrenska University Hospital, Gothenburg, Sweden, for this study. Of these participants, 17 had cervical injuries, 5 had thoracic injuries, and 7 had injuries in the lumbar area of the spine. The average age of the participants was 42 years old. In addition, 25 of the participants were men and 4 were women. Participants were included if they could understand the Swedish language and their SCL was classified as grade A, B, or C according to the American Spinal Injury Association/International Medical Society of Paraplegia classification.
Participants were evaluated every second week by a physiotherapist with the Spinal Cord Index of Function and the Swedish physiotherapy clinical outcome variables (S-COVS). The S-COVS includes clinical outcome variables such as walking and arm function. It has been shown to be valid and reliable for a sample of geriatric patients, but validity and reliability have not been adequately established for people with SCL. Participants continued with rehabilitation until discharge or until they were classified as grade D according to the American Spinal Injury Association/International Medical Society of Paraplegia classification. The evaluations occurred between 8 and 38 weeks, with an average of 19 weeks.
The two measures, the Spinal Cord Index of Function and the S-COVS, were found to be highly correlated, which suggests that the Spinal Cord Index of Function is a valid instrument. S-COVS was also shown to account for 87% of the variability within the Spinal Cord Index of Function scores. Additionally, the Spinal Cord Index of Function indicated a high magnitude of change between the time study evaluations began and discharge. The high amount of change established the measure's responsiveness to changes in participants.
The results of this study indicate that the Spinal Cord Index of Function is a valid and responsive instrument. As a result of the establishment of validity and responsiveness, the measure has many potential uses. Physiotherapists will be able to evaluate the rehabilitation progress of a person with SCL because it is helpful in identifying treatment goals by pointing out which movements require more instruction. Researchers will also be able to use the Spinal Cord Index of Function in studies related to people with SCL and functional ability.