CHART was designed to measure the level of handicap in a community setting (WHO 1980). Basically, CHART collects information on the degree to which the respondent fulfills the roles typically expected from people without disabilities. A short form (CHART-SF) has been developed (Whiteneck et al. 1992).

Number of items: 32 (short form = 19 questions)

Procedure/Administration: The questions can be answered in a quantifiable, behavioral terms (e.g.: hours of physical assistance, how much time is someone with you to assist you, how many relatives do you visit, etc.).

How scored: For each CHART dimension, a scoring procedure allows a score from 0 to 100 points, the latter being the maximum attainable corresponding to a role fulfillment equivalent to that of most individuals without disabilities

Interpretability: Norms and profiles of handicap have been widely published. Total scores can be a misleading assessment of handicap, thus the use of subscales is recommended

Acceptability: The CHART is widely used, particularly in the U.S. National Spinal Cord Injury Database.  However, questions on cognitive independence might be seen as irrelevant in SCI population.

Languages: N/a

Usability: N/a

Time to administer: N/a

Time to score: N/a

Training required: None.

Availability: N/a

Equipment required: N/a

Summary:

• The CHART is a relatively simple procedure based on strong methodological studies that showed a good level of reliability and validity.

Psychometric Summary

Note: TR= Test re-test; IC= Internal Consistency; Inter-O= Inter-observer; Intra-O= Intra-observer; SS= Sensitivity/Specificity; PR= Proxy-subject reliability; N/a= No information.

Red light= A single study involving SCI subjects which has less than adequate findings of reliability, validity, and/or responsiveness.

Yellow light= A single study involving subjects with SCI which has adequate to excellent findings of reliability, validity, and/or responsiveness.

Green light= At least 2 studies involving subjects with SCI which have adequate to excellent findings of reliability, validity, and/or responsiveness.

References

• Cusick C, Brook C, Whiteneck G. The Use of Proxies in Community Integration Research. Arch Phys Med Rehabil 2001;82:1018-1024.
• Hall KM, Cohen ME, Wright J, Call M, Werner P. Characteristics of the Functional Independence Measure in traumatic spinal cord injury. Arch Phys Med Rehabil 1999;80:1471-1476.
• Whiteneck G, Charlifue S, Gerhart K, Overholser J, Richardson G. Quantifying handicap: a new measure of long-term rehabilitation outcomes. Arch Phys Med Rehabil 1992;73:519-526.
• World Health Organization. International Classification of Functioning, Disability and Health. Geneva, Switzerland: World Health Organization, 1980.