Itzkovich M, Gelernter I, Biering-Sorensen F, Weeks C, Laramee M T, Craven B C, Tonack M, Hitzig S L, Glaser E, Zeilig G, Aito S, Scivoletto G, Mecci M, Chadwick R J, El Masry W S, Osman A, Glass C A, Silva P, Soni B M, Gardner B P, Savic G, Bergström E M, Bluvshtein V, Ronen J, Catz A
Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel.
Disabil Rehabil. 2007 Dec 30;29(24):1926-33. doi: 10.1080/09638280601046302. Epub 2007 Mar 5.
To examine the third version of the Spinal Cord Independence Measure (SCIM III) for reliability and validity in a multi-center cohort study.
Four hundred and twenty-five patients with spinal cord lesions from 13 spinal cord units in six countries from three continents were assessed with SCIM III and the Functional Independence measure (FIM) on admission to rehabilitation and before discharge.
Total agreement between raters was above 80% in most SCIM III tasks, and all kappa coefficients were statistically significant (P<0.001). The coefficients of Pearson correlation between the paired raters were above 0.9, and intraclass correlation coefficients were above 0.94. Cronbach's alpha was above 0.7. The coefficient of Pearson correlation between FIM and SCIM III was 0.790 (P<0.01). SCIM III was more responsive to changes than FIM in the subscales of Respiration and sphincter management and Mobility indoors and outdoors.
The results support the reliability and validity of SCIM III in a multi-cultural setup. Despite several limitations of the study, the results indicate that SCIM III is an efficient measure for functional assessment of SCL patients and can be safely used for clinical and research trials, including international multi-center studies.
在一项多中心队列研究中检验脊髓独立测量量表第三版（SCIM III）的信度和效度。
来自三大洲六个国家13个脊髓损伤治疗单元的425例脊髓损伤患者在康复入院时和出院前接受了SCIM III和功能独立性测量量表（FIM）评估。
在大多数SCIM III任务中，评估者之间的总体一致性超过80%，所有kappa系数均具有统计学意义（P<0.001）。配对评估者之间的Pearson相关系数高于0.9，组内相关系数高于0.94。Cronbach's alpha高于0.7。FIM与SCIM III之间的Pearson相关系数为0.790（P<0.01）。在呼吸与括约肌管理以及室内外活动亚量表中，SCIM III比FIM对变化更敏感。
结果支持SCIM III在多元文化背景下的信度和效度。尽管本研究存在一些局限性，但结果表明SCIM III是脊髓损伤患者功能评估的有效工具，可安全用于临床和研究试验，包括国际多中心研究。
