Spinal Cord Injury Clinical Trial
Official title:
United States Multi-Center Study to Assess the Validity and Reliability of the Spinal Cord Independence Measure (SCIM III)
In the past two decades there have been great strides made in understanding the biological
changes resulting from spinal cord injury (SCI). The future holds promise of the development
of therapies that will promote degrees of repair and recovery of function for people living
with SCI. Lessons learned from past "failed" SCI clinical trials, however, demonstrate that,
in order to accurately evaluate the overall effectiveness of SCI therapies, more sensitive
outcomes measures are needed. Specifically, and reflecting the ultimate goal of clinical
interventions - inducing functional recovery - the Spinal Cord Independence Measure (SCIM),
has been recommended for further testing and development for use as a measure of functional
ability in future SCI clinical studies. The SCIM is a very simple questionnaire and score
sheet that an evaluator uses to determine how independently a person with SCI can perform
certain tasks.
A panel of SCI researchers recommended the SCIM as the most suitable among four candidate
measures of functional recovery reviewed at a special meeting sponsored by the National
Institute on Disability and Rehabilitation Research (NIDRR) at a joint meeting of the
American Spinal Injury Association and the International Spinal Cord Society (ASIA-ISCoS) in
Boston, MA, in June 2006. It was recommended that a large-scale, multi-center, prospective
trial be conducted in the United States, which would mirror a recently published multi-site
international study.
The proposed research on the SCIM III, the latest and most sensitive version of the SCIM,
would test the hypothesis that the SCIM III is a valid, reliable, and sensitive measure of
functional ability in persons with SCI. Twenty-two rehabilitation centers throughout the
United States will enroll a maximum of 660 subjects. Functional ability will be measured
with the SCIM III during the first week of admittance into inpatient acute rehabilitation
and within one week of discharge from the same rehabilitation program. Statistical analyses
will be used to test the validity, reliability, and sensitivity of the SCIM III. The results
will demonstrate whether the SCIM III is a suitable outcome measure to assess SCI specific
functional ability in future clinical trials.
STUDY PURPOSE This clinical research study will be performed to assess the validity,
reliability, and sensitivity of the Spinal Cord Independence Measure (SCIM III) in measuring
functional ability in persons with spinal cord injury (SCI).
Aims and Hypothesis:
Overall hypothesis - The SCIM III is a valid, reliable, and sensitive measure of functional
ability in persons with SCI.
Aim 1: Examine the validity of the SCIM III as an outcome measure to assess functional
ability in persons with SCI.
1. Criterion-related validity
2. Construct validity of components
Aim 2: Examine the reliability of SCIM III evaluations.
1. Inter-rater reliability
2. Internal consistency
Aim 3: Examine the sensitivity of the SCIM III to functional change.
1. Sensitivity to functional change compared to the Functional Independence Measure (FIM).
2. Sensitivity to functional change over time
STUDY DESIGN This is a multi-center, prospective clinical research study performed to assess
the validity, reliability, and sensitivity of the Spinal Cord Independence Measure (SCIM
III) in measuring functional ability in persons with spinal cord injury (SCI).
UCI will act as the coordinating center for this study, collecting and performing
statistical data analysis. There will be approximately 22 rehabilitation centers
participating in this study. De-identified data will be transferred from these sites to Dr.
Kim Anderson at UCI.
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Observational Model: Case Control, Time Perspective: Prospective
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