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Spinal Cord Injury Functional Ambulation Profile: a preliminary look at responsiveness. | LitMetric

Spinal Cord Injury Functional Ambulation Profile: a preliminary look at responsiveness.

Phys Ther

K.E. Musselman, PhD, MSc, BScPT, BSc, School of Physical Therapy, St Andrew's College, University of Saskatchewan, Saskatoon, Saskatchewan, Canada. Dr Musselman was affiliated with Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland, at the time the study was conducted.

Published: February 2014

Background: The Spinal Cord Injury Functional Ambulation Profile (SCI-FAP) is a valid, reliable measure of walking skill (eg, walking while negotiating obstacles, doors, and stairs).

Objective: The responsiveness of the SCI-FAP was assessed at least 7 months after spinal cord injury (SCI) and compared with that of the 10-Meter Walk Test (10MWT) and the Six-Minute Walk Test (6MWT).

Design: A secondary analysis of data collected during a randomized, single-blind, crossover trial was performed.

Methods: Participants had incomplete SCI and could walk at least 5 m without manual assistance. After 3 or 4 baseline assessments, participants completed 2 months of precision training (stepping over obstacles and onto targets on the ground) and 2 months of endurance training (treadmill training with body weight support, if needed). Walking function was assessed with the SCI-FAP, 10MWT, and 6MWT. Internal responsiveness was evaluated through change scores and standardized response means (SRMs). External responsiveness was gauged by correlating change scores on the SCI-FAP, 10MWT, and 6MWT. The minimal detectable change was calculated from the standard error of measurement from the baseline assessments.

Results: The SCI-FAP scores improved with both interventions. The magnitude of change was greater for participants whose pretraining self-selected speed was less than 0.5 m/s. The SCI-FAP had moderate SRMs. The 10MWT (fastest speed) and 6MWT had the largest SRMs after precision training and endurance training, respectively. The minimal detectable change in the SCI-FAP was 96 points.

Limitations: The convenience sample was small and all participants could ambulate independently (with devices); therefore, the generalizability of the findings is limited.

Conclusions: The SCI-FAP was responsive to changes in walking ability in participants who had incomplete SCI and walked at slow speeds, but overall the 10MWT and 6MWT were more responsive.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3912625PMC
http://dx.doi.org/10.2522/ptj.20130071DOI Listing

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