Reliability and discriminative ability of the spinal cord independence measure III (Thai version).

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To translate and assess the reliability and discriminative ability of the Spinal Cord Independence Measure III (SCIM III), Thai version (Th-SCIM III). SETTING: A tertiary rehabilitation center in Thailand. METHODS: The SCIM III was translated into the Thai version with a forward-backward translation. The tool was then used by three physical therapists to assess 31 subjects with various degrees of spinal cord injury (SCI) during the first week after admission. RESULTS: The Th-SCIM III had excellent inter-rater reliability (intraclass correlation coefficient >0.90) and good internal consistency (Cronbach's alpha ⩾ 0.88), and could significantly discriminate between the performance of subjects with varying degrees of lesion severity. Scores of 50 and over could moderately discriminate between subjects with motor complete SCI and incomplete SCI (sensitivity 68.75%, specificity 66.67%, 95% confidence interval=0.62-0.95). CONCLUSION: The findings support the reliability and discriminative ability of the Th-SCIM III. The tool may benefit clinical assessments for overall aspects relating to SCI, particularly for Thai physical therapists. However, a further exploration of other psychometric properties may enhance the clinical utility of the tool.

Ambulatory assistive devices and walking performance in patients with incomplete spinal cord injury.

STUDY DESIGN: A cross-sectional study. OBJECTIVES: To primarily explore types of ambulatory assistive device (AAD) used and secondarily describe walking performance in independent ambulatory patients with spinal cord injury (SCI) who walked without and with various AADs as determined using walking speed and distance walked in 6 min. SETTING: A tertiary rehabilitation center and community hospitals, Thailand. METHODS: The data of 195 independent ambulatory patients with SCI were used to describe the use of an AAD. Among these, only 140 subjects were assessed for their walking speed and distance walked in 6 min. RESULTS: More than half of the subjects (64%) walked with an AAD in which most of them used a standard walker (45%), followed by a single-tip cane (11%) and bilateral crutches (8%), respectively. The walking speed and distance showed significant differences among the groups (P<0.001), except those who used walker versus crutches, and those who used crutches versus cane (P>0.05). Among the significant variables, types of AAD used had the greatest influence on walking speed and distance of the subjects. CONCLUSION: More than half of ambulatory subjects with SCI walked with an AAD in which most of them used a standard walker. However, the non-significant differences of walking performance between the groups may suggest the heterogeneity of walking ability in subjects who used the same type of AAD. Therefore, a method to facilitate the use of an AAD with less supportive ability would increase levels of independence for the patients.