Expected spinal cord independence measure, third version, scores for various neurological levels after complete spinal cord lesions

Abstract

15Rovisco Pais Spinal Centre, Lisbon, Portugal Study design: Multicenter international cohort study. Objective: The objective of this study was to establish target values for Spinal Cord Independence Measure (SCIM) III scoring in rehabilitation for clinically complete spinal cord lesion (SCL) neurological levels. Setting: In total, 13 spinal cord units in six countries from North America, Europe and the Middle East were taken. Methods: Total SCIM III scores and gain at discharge from rehabilitation were calculated for SCL levels in 128 patients with American Spinal Injury Association Impairment Scale (AIS) grade A on admission to rehabilitation. Results: Median, quartiles, mean and s.d., values of discharge SCIM III scores and SCIM III gain for the various SCL levels are presented. Total SCIM III scores and gain were significantly correlated with the SCL level (r ¼ 0.730, r ¼ 0.579, Po0.001). Conclusions: Calculated discharge SCIM III scores can be used as target values for functional achievements at various neurological levels in patients after AIS A SCL. They are generally, but not always, inversely correlated with SCL level.

Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury

“…For all neurological levels, median score gains for stair management and ground-to-wheelchair transfers were zero. Maximum observed final scores for specific neurological levels are compared with final outcomes following classic inpatient rehabilitation 4 and presented in Table 6.…”

“…3,4 Studies highlight the benefits of significant cost reductions and continued high-quality care by using a combination of inpatient and outpatient programs.…”

“…They used a multidisciplinary approach and demonstrated independence levels comparable with inpatient rehabilitation programs (in patients who had already undergone a brief inpatient program). 3,4 Outpatient day programs were considered to be extensions of inpatient rehabilitation, which helped reduce the length of hospitalization. These programs have uniformly used the Spinal Cord Independence Measure (SCIM) III scale as a reliable and a valid instrument to measure changes in functional outcomes.…”

The spinal cord independence measure (SCIM)-III self report for youth

“…Three large-scale adult studies [3][4][5] established moderate-tostrong reliability and validity and showed that when compared with the FIM (Functional Independence Measure) the SCIM-III had broader content range and was more responsive to change. Additional work has examined clinically important differences in SCIM-III scores, 6 established target values for neurological levels in complete SCI 7 and has validated a self-report version. 8 The self-report version offers a practical alternative to the performance-based version, especially in community-based centers and for longitudinal monitoring.…”

“…To move around I use a wheelchair to move around and A. I need total assistance [0] A. I always need help to move my wheelchair [0] B. I need an electric wheelchair or partial assistance to operate a manual wheelchair [1] B. I need a power wheelchair or some help to move my manual wheelchair [1] C. I am independent in a manual wheelchair [2] C. I do not need a power wheelchair and I do not need help to move my manual wheelchair [2] I walk moderate distances and I I walk medium distances and D. need supervision while walking (with or without walking aids) [3] D. Someone is always with me [3] E. walk with a walking frame or crutches, swinging forward with both feet at a time [4] E. I walk with a walker or crutches by swinging both legs and feet together [4] F. walk with crutches or two canes, setting one foot before the other [5] F. I walk with a walker or crutches by moving one foot forward at a time [5] G. walk with one cane [6] G. I walk with one crutch [6] H. walk with a leg orthosis(es) only (e.g. leg splint) [7] H. I walk with braces on my legs and do not need a walker or crutches [7] I. walk without walking aids [8] I. I walk with nothing to help me [8] CONFLICT OF INTEREST The authors declare no conflict of interest.…”