A Pilot Study to Modify the SF-36V Physical Functioning Scale for Use With Veterans With Spinal Cord Injury

Quality of life instruments and definitions in individuals with spinal cord injury: a systematic review

“…The modifications generally involved substituting activities more appropriate to SCI clients, such as 'climbingy wheel chair ramps' rather than stairs, or 'getting up and down from a curb.' 19 The SF-36V supported the authors' hypothesis that it more accurately reflects SCI QOL, showing internal validity with the physical, but not the mental component score. It was necessary to alter the wording of the questions based on SCI consumer input more than anticipated, and mobility was rated as if respondents were using their assistive devices.…”

“…In the SF-36, concern has been expressed in the SCI community regarding the appropriateness of the use of the term 'walking' in the mobilityrelated physical questions of the SF-36. 5,19 This concern has been addressed in the SF-36V, which requires further investigation before wide-spread use with SCI populations. The SF-12 and SF-6D also exhibit certain SCI bias and floor effects 5,18 that could easily be removed if they were derived from the SF-36V, as opposed to the original SF-36.…”

“…Most authors clearly distinguish their instrument or definition of QOL as objective 5,16,[18][19][20] or subjective. 1,6,9,20,21 Where no distinction was specified, instruments were classified according to the authors' definition of QOL 7 and/or the item content and scoring model.…”

Short Form health surveys and related variants in spinal cord injury research: A systematic review

“…One-off modifications of standardized health surveys are inappropriate if undertaken without any assessment of measurement properties -an issue acknowledged by some authors who have used modified instruments. 28,29,45 Even if a modified health survey demonstrates good psychometric performance in a particular setting, the value of such a measure is negligible if it is not used in subsequent studies and does not undergo further validation testing. Similarly, evidence for the validity of individual domains or items within SCI populations is necessary to justify the chosen analytic approach.…”

“…Although the exact changes are not discernible from the paper alone, the authors describe them as, 'For example 'climbing stairs or walking more than a mile' was changed to 'propelling up a steep ramp or pushing more than a mile.' Modification 5 (Luther et al, 2006 45 ) The objective of this study was to revise items of the VR-36 physical functioning scale to be more appropriate for use with people with SCI. The result was a set of 8 items that were considerably different from the original items Modification 6 (Kalpakjian et al, 2007 46 ) Text for both items of the SF-12 physical functioning scale were amended; '…moving a table, pushing a vacuum cleaner, bowling, or playing golf' was changed to '…pushing a vacuum cleaner, or climbing 1 flight of stairs/ramp', and 'Climbing several flights of stairs' was changed to 'Climbing several flights of stairs/ramps'…”