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The spinal cord independence measure (SCIM): sensitivity to functional changes in subgroups of spinal cord lesion
A Catz1, M Itzkovich, E Agranov
1Loewenstein Rehabilitation Hospital, Raanana and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Background:
The spinal cord independence measure (SCIM) is a newly developed disability scale specific to patients with spinal cord lesions (SCL). Its sensitivity to functional changes in a whole cohort of SCL patients was found to be better than that of the functional independence measure (FIM).
Objective:
o compare the sensitivity to functional changes of the SCIM and the FIM in SCL subgroups.
Design:
A comparative self-controlled study.
Setting:
The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel.
Subjects:
22 SCL inpatients.
Interventions:
Monthly SCIM and FIM assessments of the subgroups.
Main Outcome Measures:
Functional change detection rate (FDR) and mean differences between consecutive scores (DCS).
Results:
The outcome measures of the SCIM were higher than those of the FIM for tetraplegia and paraplegia, complete and incomplete lesions (the FIM missed 25-27% of the functional changes detected by the SCIM; DSC 8.2-11.4 vs 5.2-9; P<0.05 in most comparisons). The SCIM did not exhibit this advantage, however, in the functional areas of self-care and mobility in the room and toilet. Further subgrouping yielded similar results.
Conclusions:
The SCIM is more sensitive than the FIM to functional changes in the subgroups studied, and has the potential to serve as a universal tool for disability assessment of SCL patients.