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
An evaluation of image distortion and serial variation in oblique cephalometric radiography. Reduction of inaccuracies from these sources is best achieved by aligning images of the inferior border of the mandible directly underlying the structures under study.
Subject(s)
Cephalometry/methods , Anxiety/physiopathology , Cephalometry/instrumentation , Diagnostic Errors , Equipment Design , Face/anatomy & histology , Humans , Mandible/anatomy & histology , Mandible/physiology , Movement , Radiographic Image Enhancement , Rotation , Vertical DimensionABSTRACT
The average 5 year reduction of the occluding vertical dimension (nasion to menton) for 45 patients was 3.2mm. (2.8 mm. for the anatomic group, 3.2 mm. for the semianatomic group, and 3.6 mm. for the nonanatomic group, each constituting 15 patients). Mandibular physiologic resting face height became foreshortened on the average only one third as much as the morphologic centric occlusion face height. Tabulation of adjustments for sore spots indicated that: the fewest postinsertion appointments were required for the anatomic group of patients; three fourths of 604 denture base alterations were on lower dentures; for upper and lower denture base alterations, one third were made on the borders and two thirds, on the basal seat; one sixth of all alterations were made at routine recall examinations; the fewest upper denture base alterations were for the nonanatomic patients; and the fewest adjustments of the lower denture base on the tissue surface and on the borders were done for the anatomic group of patients. This investigation has been underway for 18 years, and several more re
