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Validation of the Spinal Cord Injury Functional Index (SCI-FI) for use in community dwelling individuals with SCI.

OBJECTIVE: To evaluate the psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) instruments in a community-dwelling sample.

DESIGN: Cross-sectional study.

SETTING: Community setting.

PARTICIPANTS: 269 individuals recruited from six SCI Model Systems sites.

INTERVENTIONS: n/a MAIN OUTCOME MEASURES: Participants completed computer adaptive test (CAT) and short form versions of four SCI-FI/Capacity banks (SCI-FI/C; Ambulation, Basic Mobility, Fine Motor, Self-Care) and one SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after two weeks. The Self Report Functional Measure (SRFM) and the clinician-rated motor Functional Independence Measure (FIM) were used to evaluate evidence of convergent validity.

RESULTS: Pearson correlations, intraclass correlation coefficients, minimal detectable change, and Bland-Altman plots supported the test-retest reliability of the SCI-FI instruments. Correlations were large with the SRFM (.69-.89) and moderate-to-large for the FIM instrument (.44-.64), supporting convergent validity. Known-groups validity was demonstrated by a significant main effect of injury level on all instruments and a main effect of injury completeness on the SCI-FI/C instruments. A ceiling effect was detected for individuals with incomplete paraplegia on the Fine Motor/C and Self Care/C Short Forms.

CONCLUSION: Findings support the test-retest reliability, convergent validity, and known-groups validity of the SCI-FI/C instruments and the SCI-FI/AT Wheelchair Mobility instruments for use by community-dwelling individuals.

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