Predictive validity and responsiveness of the Spinal Cord Independence Measure (SCIM III) in Veterans with Spinal...

Spinal Cord Injuries (SCI) greatly affect physical independence, especially in older Veterans. While the Functional Independence Measure (FIM) is widely used in rehabilitation, it lacks consideration of SCI-specific needs such as ventilation, wheelchair use, and bowel/bladder management. The Spinal Cord Independence Measure-Version III (SCIM-III) was developed to address these gaps, but its effectiveness has not been studied in the veteran population, which is typically older, predominantly male, and has higher comorbidity rates. This study examined the concurrent validity, responsiveness, and predictive value of FIM and SCIM-III for length of stay (LOS) and discharge destinations in older Veterans with SCI.

This retrospective cohort study used data from an acute rehabilitation program (March 2021-May 2023) and included 33 adults (≥18 years) with a recent SCI (≤1 year) and a minimum one-week admission. Collected data included demographics, AIS level, injury type/duration, length of stay, and discharge destination.

The SCIM-III demonstrated acceptable concurrent validity with the FIM, and both the FIM and SCIM-III were responsive to change. Neither measure was a significant predictor of discharge outcome. The SCIM-III admission score significantly predicted LOS, whereas the FIM admission total score did not significantly predict LOS.

SCIM-III demonstrates acceptable concurrent validity and responsiveness to change when compared with FIM. Only the SCIM-III admission scores predicted LOS. These initial findings suggest the utility of the SCIM-III for improving clinical care and discharge planning among Veterans.