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.

Functional abilities, incidences of complications and falls of patients with spinal cord injury 6 months after discharge.

STUDY DESIGN: A prospective study. OBJECTIVES: To evaluate the changes of functional abilities, incidences of complications and falls of patients with spinal cord injury (SCI) 6 months after discharge. SETTING: A major tertiary referral hospital, Thailand. METHODS: Forty-four patients with SCI completed the study. Their average age and post-injury time were 45.23±13.78 years and 51.52±47.87 months respectively. Functional abilities of the subjects were measured by using the Spinal Cord Independence Measure II (SCIM II). Incidences of complications and falls were prospectively assessed every month by using a questionnaire. RESULTS: After 6 months, the SCIM II scores of subjects showed a slight decrease (58.60±21.22-58.37±22.06 scores). The significant decrement was illustrated in self-care and mobility scores of subjects with chronic motor incomplete SCI (P<0.05). Forty subjects experienced at least one medical complication (range 1-5 times) which 11 of them had to re-admit for 3-30 days. Twenty-four subjects sustained at least one fall in 6 months (range 1-24 times) which one subject had metatarsal bone fracture after fall. CONCLUSION: The functional ability of subjects with SCI, particularly those with chronic motor incomplete SCI, significantly decreased after discharge. The subjects also encountered a high risk of complications and falls that might associate with the decrement of functional ability. The findings confirmed important roles of community rehabilitation after discharge.