Catz A, Itzkovich M, Agranov E, Ring H, Tamir A
Loewenstein Rehabilitation Hospital, Raanana, Israel.
Spinal Cord. 1997 Dec;35(12):850-6. doi: 10.1038/sj.sc.3100504.
The Spinal Cord Independence Measure (SCIM) is a new disability scale developed specifically for patients with spinal cord lesions in order to make the functional assessments of patients with paraplegia or tetraplegia more sensitive to changes. The SCIM includes the following areas of function: self-care (subscore (0-20), respiration and sphincter management (0-40) and mobility (0-40). Each area is scored according to its proportional weight in these patients' general activity. The final score ranges from 0 to 100. This study was performed to evaluate the reliability of the SCIM and its sensitivity to functional changes in spinal cord lesion patients compared with the Functional Independence Measure (FIM). Thirty patients were included. Scores were recorded one week after admission and thereafter every month during hospitalization. Each area of function was assessed by a pair of staff members from the relevant discipline. The comparison of scores between each pair of rates revealed a remarkable consistency (r = 0.91-0.99; P < 0.0001; slope approximately 1; constant approximately 0). The total SCIM score (mean = 51, SD = 21) was lower than the total FIM score (mean = 87, SD = 23) owing to the difference in scale range structure and the relatively high cognitive scores of our patients; however, a relationship was noted between the scores of both scales (r = 0.85, P < 0.01). The SCIM was more sensitive than the FIM to changes in function of spinal cord lesion patients: the SCIM detected all the functional changes detected by the FIM total scoring, but the FIM missed 26% of the changes detected by the SCIM total scoring. The mean difference between consecutive scores was higher for the SCIM (P < 0.01). We conclude that the SCIM is a reliable disability scale and is more sensitive to changes in function in spinal cord lesion patients than the FIM. The SCIM when administered by a multidisciplinary team, may be a useful instrument for assessing changes in everyday performance in patients with spinal cord lesion.
脊髓独立测量量表（SCIM）是一种专门为脊髓损伤患者开发的新残疾量表，旨在使截瘫或四肢瘫患者的功能评估对变化更加敏感。SCIM包括以下功能领域：自我护理（子评分0 - 20）、呼吸及括约肌管理（0 - 40）和活动能力（0 - 40）。每个领域根据其在这些患者日常活动中的比例权重进行评分。最终得分范围为0至100。本研究旨在评估SCIM的可靠性及其与功能独立性测量量表（FIM）相比对脊髓损伤患者功能变化的敏感性。纳入了30名患者。入院一周后记录得分，住院期间此后每月记录一次。每个功能领域由相关学科的一对工作人员进行评估。每对评分之间的比较显示出显著的一致性（r = 0.91 - 0.99；P < 0.0001；斜率约为1；常数约为0）。由于量表范围结构的差异以及我们患者相对较高的认知得分，SCIM总得分（均值 = 51，标准差 = 21）低于FIM总得分（均值 = 87，标准差 = 23）；然而，两种量表的得分之间存在相关性（r = 0.85，P < 0.01）。SCIM比FIM对脊髓损伤患者的功能变化更敏感：SCIM检测到了FIM总分所检测到的所有功能变化，但FIM遗漏了SCIM总分所检测到的26%的变化。SCIM连续得分之间的平均差异更高（P < 0.01）。我们得出结论，SCIM是一种可靠的残疾量表，并且比FIM对脊髓损伤患者的功能变化更敏感。由多学科团队进行管理时，SCIM可能是评估脊髓损伤患者日常表现变化的有用工具。
