Sensitivity of the SCI-FI/AT in Individuals with Traumatic Spinal Cord Injury

Arch Phys Med Rehabil, 2018 · DOI: 10.1016/j.apmr.2018.02.014 · Published: September 1, 2018

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study examines how well the Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) can detect changes in function for people with spinal cord injuries. The SCI-FI/AT measure includes different sections (domains) that assess abilities like basic movement, self-care, fine motor skills, wheelchair use, and walking. The study found that the SCI-FI/AT can detect improvements in function from discharge to 12 months after a spinal cord injury, but the specific areas where improvement is detected vary depending on the person's injury level (paraplegia or tetraplegia).

Study Duration

12-month follow-up

Participants

165 adults with SCI

Evidence Level

Longitudinal study

Key Findings

1
For individuals with paraplegia, the Basic Mobility, Self-Care, and Ambulation domains of the SCI-FI/AT detected a significant, large amount of change.
2
For those with tetraplegia, the Basic Mobility, Fine Motor, and Self-Care domains detected a small amount of change; while the Ambulation item domain detected a medium amount of change.
3
The Wheelchair domain for people with tetraplegia was the only SCI-FI/AT domain that did not detect significant change.

Research Summary

SCI-FI/AT CAT item banks detected an increase in function from discharge to 12-months after SCI onset. SCI-FI/AT CAT ES estimates vary by domain and level of lesion. Findings support use of the SCI-FI/AT CAT in the SCI population and highlight the importance of multidimensional functional measures.

Practical Implications

Comprehensive Assessment

SCI-FI/AT provides a multidimensional profile of functioning after a SCI, useful for a more complete understanding of a patient's abilities.

Targeted Interventions

The ability to identify domains where change has occurred enhances the clinical relevance of the SCI-FI/AT, allowing clinicians to tailor interventions.

AT Consideration

Clinicians may decide to administer the SCI-FI/C to assess underlying capacity, the SCI-FI/AT to assess function using AT, or both, depending on the assessment's purpose.

Study Limitations

1
Loss to follow-up resulted in a reduced sample size for some functional domains.
2
Analyses could not be performed stratified by ASIA category due to sample limitations.
3
This study does not establish whether functional change measured by the SCI-FI/AT, FIM, or SRFM were clinically meaningful, due to homogeneity of responses on the retrospective change assessment provided at follow-up.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury