A. Catz et al., The spinal cord independence measure (SCIM): Sensitivity to functional changes in subgroups of spinal cord lesion patients, SPINAL CORD, 39(2), 2001, pp. 97-100
Background: The spinal cord independence measure (SCIM) is a newly develope
d disability scale specific to patients with spinal cord lesions (SCL). Its
sensitivity to functional changes in a whole cohort of SCL patients was fo
und to be better than that of the functional independence measure (FIM).
Objective: To compare the sensitivity to functional changes of the SCIM and
the FIM in SCL subgroups.
Design: A comparative self-controlled study.
Setting: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanan
a, Israel.
Subjects: 22 SCL inpatients.
Interventions: Monthly SCIM and FIM assessments of the subgroups.
Main outcome measures: Functional change detection rate (FDR) and mean diff
erences between consecutive scores (DCS).
Results: The outcome measures of the SCIM were higher than those of the FIM
for tetraplegia and paraplegia. complete and incomplete lesions (the FIM m
issed 25-27% of the functional changes detected by the SCIM; DSC 8.2-11.4 t
a 5.2-9; P<0.05 in most comparisons). The SCIM did not exhibit this advanta
ge, however, in the functional areas of self-care find mobility in the room
and toilet. Further subgrouping yielded similar results.
Conclusions: The SCIM is more sensitive than the FIM to Functional changes
in the subgroups studied, and has the potential to serve as a universal too
l for disability assessment of SCL patients.