The spinal cord independence measure (SCIM): Sensitivity to functional changes in subgroups of spinal cord lesion patients

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Abstract
Background: The spinal cord independence measure (SCIM) is a newly developed disability scale specific to patients with spinal cord lesions (SCL). Its sensitivity to functional changes in a whole cohort of SCL patients was found to be better than that of the functional independence measure (FIM). Objective: To compare the sensitivity to functional changes of the SCIM and the FIM in SCL subgroups. Design: A comparative self-controlled study. Setting: The Spinal Department, Loewenstein Rehabilitation Hospital, Raanana, Israel. Subjects: 22 SCL inpatients. Interventions: Monthly SCIM and FIM assessments of the subgroups. Main outcome measures: Functional change detection rate (FDR) and mean differences between consecutive scores (DCS). Results: The outcome measures of the SCIM were higher than those of the FIM for tetraplegia and paraplegia, complete and incomplete lesions (the FIM missed 25–27% of the functional changes detected by the SCIM; DSC 8.2–11.4 vs 5.2–9; PSpinal Cord (2001) 39, 97–100.