Using the Spinal Cord Independence Measure III to measure functional recovery in a post-acute spinal cord injury program.

Study Design: A prospective design was conducted using admission and discharge Spinal Cord Independence Measure III (SCIM-III) data for persons discharged from a post-acute rehabilitation program.

Objective: The purpose of this study is to analyze the functional gains as measured by the SCIM-III that occur during a post-acute rehabilitation program.

Setting: Shepherd Center, Atlanta, GA, USA.

Methods: Participants were included if they had a motor complete spinal cord injury (SCI), were within 12 months from the date of injury and completed the recommended length of stay. Median SCIM-III changes between admission and discharge were calculated by subgroups (C1-4, C5, C6, C7-8, T1-6 and T7-12) based on the American Spinal Injury Association motor injury levels. Ceiling and floor effects were examined by item and the percentage of participants showing change between admission and discharge were calculated.

Results: In all, 114 participants were included in the analysis. The median total SCIM-III score at admission was 42 (range 13-68), whereas the median total SCIM-III score at discharge was 50 (range 16-72). The median improvement of 5 points in total SCIM-III score between admission and discharge was statistically significant. Significant improvements were also observed between admission and discharge across all subgroups except C1-4. Ceiling and floor effects were noted in some subgroups.

Conclusions: The SCIM-III seems to be an effective measure for functional assessment of persons with SCI in a post-acute rehabilitation program. There are some ceiling and floor effects noted; however, the SCIM-III seems to be sensitive enough to capture functional changes during a post-acute rehabilitation program.