A review of instruments assessing participation in individuals with spinal cord injury

Spinal Cord, 2009 · DOI: 10.1038/sc.2008.171 · Published: June 1, 2009

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

This paper reviews different ways to measure how well people with spinal cord injuries (SCI) are able to participate in life activities. The review looks at various questionnaires and scales used to assess participation, considering how reliable and valid they are for individuals with SCI. The goal is to help clinicians and researchers choose the best tools to measure participation and understand the impact of SCI on people's lives.

Study Duration

1980 to March 2008

Participants

Adults with spinal cord injury

Evidence Level

Systematic review

Key Findings

1
Six instruments were included: Craig Handicap Assessment and Reporting Technique (CHART); Impact on Participation and Autonomy Questionnaire (IPA); Assessment of Life Habits Scale (Life-H); Occupational Performance History Interview (OPHI); Physical Activity Recall Assessment for People with Spinal Cord Injury (PARA-SCI); and Reintegration to Normal Living Index (RNL).
2
The CHART instrument has the most evidence supporting its measurement properties.
3
More recently participation has been operationalized to consider the person’s perspective and in the future more evidence will be available for instruments such as the IPA in persons with SCI.

Research Summary

This review examined six instruments used to measure participation in individuals with SCI, evaluating their measurement properties such as reliability and validity. The CHART demonstrated the most robust evidence for its measurement properties, while other instruments like the IPA are increasingly incorporating the individual's perspective on participation. The review highlights the importance of selecting appropriate measures to assess participation and emphasizes the need for further research to establish the measurement properties of existing and newly developed instruments in the SCI population.

Practical Implications

Instrument Selection

Clinicians and researchers can use this review to inform their selection of appropriate instruments for measuring participation in individuals with SCI.

Future Research

The review identifies areas for future research, such as establishing the responsiveness of existing instruments and developing new instruments with strong measurement properties.

Conceptual Clarity

The discussion on the operationalization of participation and the distinction between activity and participation can guide the development of more precise and meaningful measures.

Study Limitations

1
Limited evidence on the responsiveness of the instruments.
2
Variability in the conceptual models used to develop the instruments makes it difficult to compare their content.
3
The review only included studies published in English.

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