ABSTRACT
STUDY DESIGN: Multi-center, prospective, cohort study. OBJECTIVES: To assess the validity and reliability of the Spinal Cord Independence Measure (SCIM III) in measuring functional ability in persons with spinal cord injury (SCI). SETTING: Inpatient rehabilitation hospitals in the United States (US). METHODS: Functional ability was measured with the SCIM III during the first week of admittance into inpatient acute rehabilitation and within one week of discharge from the same rehabilitation program. Motor and sensory neurologic impairment was measured with the American Spinal Injury Association Impairment Scale. The Functional Independence Measure (FIM), the default functional measure currently used in most US hospitals, was used as a comparison standard for the SCIM III. Statistical analyses were used to test the validity and reliability of the SCIM III. RESULTS: Total agreement between raters was above 70% on most SCIM III tasks and all κ-coefficients were statistically significant (P<0.001). The coefficients of Pearson correlation between the paired raters were above 0.81 and intraclass correlation coefficients were above 0.81. Cronbach's-α was above 0.7, with the exception of the respiration task. The coefficient of Pearson correlation between the FIM and SCIM III was 0.8 (P<0.001). For the respiration and sphincter management subscale, the SCIM III was more responsive to change, than the FIM (P<0.0001). CONCLUSION: Overall, the SCIM III is a reliable and valid measure of functional change in SCI. However, improved scoring instructions and a few modifications to the scoring categories may reduce variability between raters and enhance clinical utility.
Subject(s)
Disability Evaluation , Spinal Cord Injuries/diagnosis , Spinal Cord Injuries/epidemiology , Activities of Daily Living , Adolescent , Adult , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Spinal Cord Injuries/rehabilitation , Statistics as Topic , United States/epidemiology , Young AdultABSTRACT
In the opossum the fundic area of the gastric mucosa develops first, and oxyntic glands show early division into gastric pits and glandular components which then grow simultaneously. At 40 d postnatum the oxyntic glands are longer than the gastric pits but in the pyloric glands the pits still are longer than the glands and it is not until the 73rd postnatal day, that pyloric glands are longer than their pits. Development of the cardiac glands is delayed even more and the length of the gland does not surpass that of the pit until about 95 d postnatum. Argyrophil cells are concentrated in the cardia and fundus at birth and during early postnatal life, but the population of these cells shifts to the pylorus in the adult. Argyrophil cells of the cardiac, oxyntic and pyloric glands are concentrated in glandular regions with the highest mitotic activity.
