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Area of Science:

  • Rehabilitation Medicine
  • Clinical Psychology
  • Biostatistics

Background:

  • Spinal Cord Injury (SCI) significantly impacts daily living activities (ADLs).
  • Longitudinal assessment of ADL changes is crucial for effective rehabilitation planning.
  • The Spinal Cord Injury Activities of Daily Living (SCI_ADL) measure requires psychometric validation for long-term use.

Purpose of the Study:

  • To evaluate the psychometric properties of the SCI_ADL measure.
  • To determine the SCI_ADL's ability to detect ADL changes over two decades.
  • To describe self-care task performance trends in individuals with SCI over time.

Main Methods:

  • Retrospective longitudinal study using 20-year data (1993-2013).
  • Analysis of 344 adult participants with traumatic SCI, categorized by injury level (C1-C4, C5-C8, T1-S5).
  • Psychometric evaluation using factor and Rasch analyses; longitudinal changes assessed with generalized linear mixed modeling.

Main Results:

  • The SCI_ADL measure demonstrated good psychometric properties, including unidimensionality and high reliability (Cronbach's α = 0.93).
  • Significant ADL decline was observed between 2003 and 2013, particularly in the C1-C4 (cervical) injury group.
  • No significant ADL changes were detected between 1993 and 2003 across all injury levels.

Conclusions:

  • The SCI_ADL measure is a valid tool for assessing longitudinal ADL changes in individuals with SCI.
  • The C1-C4 injury group exhibited the most substantial decline in ADLs, indicating a greater need for sustained rehabilitation services.
  • Findings underscore the importance of long-term monitoring and tailored support for individuals with SCI.