Enhancement and Evaluation of the SCI-FI Instrument (SCI Functional Index Computer Adaptive Testing)
Principal Investigator Name
Alan Jette, PT, PhD
Principal Investigator Email
Currently, the SCI Model Systems National Database relies on the Functional Independence Measure (FIM) to assess and track long-term functional prognosis. However, serious concerns have been raised about the appropriateness of using the FIM in the SCI population. FIM scores are insensitive to differences in function among patients with SCI who have different levels of injury severity (Hall, Cohen et al. 1999) and are insensitive to functional changes that occur after inpatient rehabilitation (Ota, Akaboshi et al. 1996; Hall, Cohen et al. 1999). In recognition of these significant limitations, seven Model Systems Centers conducted a modular project over the past 5-years. We developed a new measure that includes functional activities relevant to persons across all levels and severity of SCI injury.
The proposed study will be conducted at nine Spinal Cord Injury Model Systems (SCIMS) programs to enhance and evaluate the Spinal Cord Injury Functional Index (SCI-FI). The first aim of this study will refine and augment the original SCI-FI item banks to capture functional performance involving the full range of assistive technology (AT). Two separate scales will be developed: the SCI-FI Capacity Scale will assess functioning without the use of assistive technology (AT) and the SCI-FI Performance Scale will assess functioning using AT. The second aim of this study will be launched as a prospective, longitudinal study to assess the long-term responsiveness and the ability of the SCI-FI CAT Capacity and Performance Scales to detect clinically meaningful changes. We will examine the relative breadth of measurement, precision, and sensitivity to change.