Development and initial evaluation of the SCI-FI/AT

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Article describes the development and psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) for people using assistive technology (AT) and reports the initial psychometric properties of each domain. A cross-sectional survey followed by computerized adaptive test (CAT) simulations were conducted with 460 adults with traumatic spinal cord injury (SCI) who were recruited from 9 national SCI Model Systems programs. Participants were stratified by level of injury, completeness of injury, and time since injury. Confirmatory factor analysis (CFA) and item response theory (IRT) analyses identified 4 unidimensional SCI-FI/AT domains: (1) basic mobility (41 items), (2) self-care (71 items), (3) fine motor function (35 items), and (4) ambulation (29 items). High correlations of full item banks with 10-item simulated CATs indicated high accuracy of each CAT in estimating a person’s function, and there was high measurement reliability for the simulated CAT scales compared with the full item bank. SCI-FI/AT item difficulties in the domains of self-care, fine motor function, and ambulation were less difficult than the same items in the original SCI-FI item banks. With the development of the SCI-FI/AT, clinicians and investigators have available multidimensional assessment scales that evaluate function for users of AT to complement the scales available in the original SCI-FI.

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