TY - JOUR
T1 - Spinal cord injury-functional index
T2 - Item banks to measure physical functioning in individuals with spinal cord injury
AU - Tulsky, David S.
AU - Jette, Alan M.
AU - Kisala, Pamela A.
AU - Kalpakjian, Claire
AU - Dijkers, Marcel P.
AU - Whiteneck, Gale
AU - Ni, Pengsheng
AU - Kirshblum, Steven
AU - Charlifue, Susan
AU - Heinemann, Allen W.
AU - Forchheimer, Martin
AU - Slavin, Mary D.
AU - Houlihan, Bethlyn
AU - Tate, Denise G.
AU - Dyson-Hudson, Trevor
AU - Fyffe, Denise G.
AU - Williams, Steve
AU - Zanca, Jeanne
PY - 2012/10
Y1 - 2012/10
N2 - Tulsky DS, Jette AM, Kisala PA, Kalpakjian C, Dijkers MP, Whiteneck G, Ni P, Kirshblum S, Charlifue S, Heinemann AW, Forchheimer M, Slavin MD, Houlihan B, Tate DG, Dyson-Hudson T, Fyffe D, Williams S, Zanca J. Spinal Cord Injury-Functional Index: item banks to measure physical functioning in individuals with spinal cord injury. Objectives: To develop a comprehensive set of patient-reported items to assess multiple aspects of physical functioning relevant to the lives of people with spinal cord injury (SCI), and to evaluate the underlying structure of physical functioning. Design: Cross-sectional. Setting: Inpatient and community. Participants: Item pools of physical functioning were developed, refined, and field tested in a large sample of individuals (N=855) with traumatic SCI stratified by diagnosis, severity, and time since injury. Interventions: None. Main Outcome Measure: Spinal Cord Injury-Functional Index (SCI-FI) measurement system. Results: Confirmatory factor analysis (CFA) indicated that a 5-factor model, including basic mobility, ambulation, wheelchair mobility, self-care, and fine motor function, had the best model fit and was most closely aligned conceptually with feedback received from individuals with SCI and SCI clinicians. When just the items making up basic mobility were tested in CFA, the fit statistics indicated strong support for a unidimensional model. Similar results were demonstrated for each of the other 4 factors, indicating unidimensional models. Conclusions: Though unidimensional or 2-factor (mobility and upper extremity) models of physical functioning make up outcomes measures in the general population, the underlying structure of physical function in SCI is more complex. A 5-factor solution allows for comprehensive assessment of key domain areas of physical functioning. These results informed the structure and development of the SCI-FI measurement system of physical functioning.
AB - Tulsky DS, Jette AM, Kisala PA, Kalpakjian C, Dijkers MP, Whiteneck G, Ni P, Kirshblum S, Charlifue S, Heinemann AW, Forchheimer M, Slavin MD, Houlihan B, Tate DG, Dyson-Hudson T, Fyffe D, Williams S, Zanca J. Spinal Cord Injury-Functional Index: item banks to measure physical functioning in individuals with spinal cord injury. Objectives: To develop a comprehensive set of patient-reported items to assess multiple aspects of physical functioning relevant to the lives of people with spinal cord injury (SCI), and to evaluate the underlying structure of physical functioning. Design: Cross-sectional. Setting: Inpatient and community. Participants: Item pools of physical functioning were developed, refined, and field tested in a large sample of individuals (N=855) with traumatic SCI stratified by diagnosis, severity, and time since injury. Interventions: None. Main Outcome Measure: Spinal Cord Injury-Functional Index (SCI-FI) measurement system. Results: Confirmatory factor analysis (CFA) indicated that a 5-factor model, including basic mobility, ambulation, wheelchair mobility, self-care, and fine motor function, had the best model fit and was most closely aligned conceptually with feedback received from individuals with SCI and SCI clinicians. When just the items making up basic mobility were tested in CFA, the fit statistics indicated strong support for a unidimensional model. Similar results were demonstrated for each of the other 4 factors, indicating unidimensional models. Conclusions: Though unidimensional or 2-factor (mobility and upper extremity) models of physical functioning make up outcomes measures in the general population, the underlying structure of physical function in SCI is more complex. A 5-factor solution allows for comprehensive assessment of key domain areas of physical functioning. These results informed the structure and development of the SCI-FI measurement system of physical functioning.
KW - Activities of daily living
KW - Mobility limitation
KW - Outcome assessment (health care)
KW - Psychometrics
KW - Quality of life
KW - Rehabilitation
KW - Self care
KW - Spinal cord injuries
KW - Walking
UR - http://www.scopus.com/inward/record.url?scp=84866401369&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2012.05.007
DO - 10.1016/j.apmr.2012.05.007
M3 - Article
C2 - 22609299
AN - SCOPUS:84866401369
SN - 0003-9993
VL - 93
SP - 1722
EP - 1732
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 10
ER -