The spinal cord independence measure (SCIM): sensitivity to functional changes in subgroups of spinal cord lesion patients.

Abstract

The spinal cord independence measure (SCIM) is a newly developed disability scale specific to patients with spinal cord lesions (SCL). Its sensitivity to functional changes in a whole cohort of SCL patients was found to be better than that of the functional independence measure (FIM). o compare the sensitivity to functional changes of the SCIM and the FIM in SCL subgroups. A comparative self-controlled study. The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. 22 SCL inpatients. Monthly SCIM and FIM assessments of the subgroups. Functional change detection rate (FDR) and mean differences between consecutive scores (DCS). The outcome measures of the SCIM were higher than those of the FIM for tetraplegia and paraplegia, complete and incomplete lesions (the FIM missed 25-27% of the functional changes detected by the SCIM; DSC 8.2-11.4 vs 5.2-9; P<0.05 in most comparisons). The SCIM did not exhibit this advantage, however, in the functional areas of self-care and mobility in the room and toilet. Further subgrouping yielded similar results. The SCIM is more sensitive than the FIM to functional changes in the subgroups studied, and has the potential to serve as a universal tool for disability assessment of SCL patients.