Spinal cord ability ruler: an interval scale to measure volitional performance after spinal cord injury

Abstract

SCAR is a quantitative linear measure of volitional performance across an inclusive range of tetraplegic and paraplegic SCI.

The Spinal Cord Ability Ruler (SCAR) complements the Spinal Cord Independence Measure (SCIM)

“…We thank Amiram Catz and colleagues for providing an opportunity to clarify any misunderstandings about our recent paper [1] that addressed how to better measure a treatment effect in a clinical trial after spinal cord injury (SCI). To increase the acceptance of SCAR by clinical investigators, the tool evolved through Rasch analysis of current assessment tools that could be modified to track changes in voluntary motor activities during recovery from SCI [1]. Although it incorporates some transformed items from the Spinal Cord Independence Measure (SCIM), as well as upper extremity motor scores (UEMS), it was not intended to replace SCIM [2].…”

“…Our initial SCAR article [1] should be consulted for further justification of our hypotheses. We believe it has addressed the majority of the concerns by Professor Catz and his colleagues who developed the SCIM tool.…”

The Spinal Cord Ability Ruler (SCAR): combining aspects of two widely-used outcome measures into one

“…This edition of Spinal Cord contains some interesting correspondence about a newly proposed outcome measure called "The Spinal Cord Ability Ruler" (SCAR) [1]. The SCAR builds on the years of work of others-it does not try to reinvent the wheel.…”

“…The existing 6-point manual muscle test used in the ISNCSCI is collapsed into a 3-point score, and each of the included SCIM items is scored on a 4-point scale. A formula is used to derive an overall score of 100 points (see p.735 for details [1]). …”

“…"Volitional performance" is defined by the authors as "voluntary taskspecific physical actions contributing to independence in ADLs" (p.731) [1]. For this reason, the bladder, bowel and respiratory items of the SCIM are excluded because they are largely controlled by the autonomic nervous system.…”