Department IV, Spinal Rehabilitation, Loewenstein Rehabilitation Hospital, Raanana, Israel.
Spinal Cord. 2011 Feb;49(2):292-6. doi: 10.1038/sc.2010.111. Epub 2010 Sep 7.
A multi-center international cohort study.
To evaluate the reliability and validity of the third version of the Spinal Cord Independence Measure (SCIM III), separately for patients with traumatic spinal cord lesions (SCLs).
A total of 13 spinal cord units in six countries from North America, Europe and the Middle-East.
SCIM III and Functional Independence Measure (FIM) were assessed for 261 patients with traumatic SCLs, on admission to rehabilitation and before discharge, by two raters. Conventional statistical measures were used to evaluate the SCIM III reliability and validity.
In almost all SCIM III tasks, the total agreement between the paired raters was >80%. The κ coefficients were all >0.6 and statistically significant. Pearson's coefficients of the correlations between the paired raters were >0.9, the mean differences between raters were nonsignificant and the intraclass correlation coefficients (ICCs) were ≥ 0.95. Cronbach's α values for the entire SCIM III scale were 0.833-0.835. FIM and SCIM III total scores were correlated (r=0.84, P<0.001). SCIM III was more responsive to changes than FIM. In all subscales, SCIM III identified more changes in function than FIM, and in 3 of the 4 subscales, differences in responsiveness were statistically significant (P<0.02).
The results confirm the reliability and validity of SCIM III for patients with traumatic SCLs in a number of countries.
多中心国际队列研究。
评估第三版脊髓独立性测量（SCIM III）的可靠性和有效性，分别针对外伤性脊髓损伤（SCI）患者。
来自北美、欧洲和中东的六个国家的总共 13 个脊髓单位。
对 261 例外伤性 SCI 患者在入院康复和出院前由两名评估者分别进行 SCIM III 和功能独立性测量（FIM）评估。使用常规统计措施评估 SCIM III 的可靠性和有效性。
在几乎所有 SCIM III 任务中，配对评估者之间的总一致性>80%。κ系数均>0.6 且具有统计学意义。配对评估者之间的 Pearson 相关系数>0.9，评分者间的平均差异无统计学意义，组内相关系数（ICC）≥0.95。整个 SCIM III 量表的 Cronbach's α 值为 0.833-0.835。FIM 和 SCIM III 总分呈相关（r=0.84，P<0.001）。SCIM III 比 FIM 更能反映变化。在所有子量表中，SCIM III 识别的功能变化多于 FIM，并且在 4 个子量表中的 3 个子量表中，反应差异具有统计学意义（P<0.02）。
这些结果证实了 SCIM III 在多个国家针对外伤性 SCI 患者的可靠性和有效性。
