The Spinal Cord Independence Measure (SCIM)
The SCIM, now in its third iteration, is a new disability scale developed to specifically address the ability of SCI patients to accomplish ADLs (Catz et al. 1997). The SCIM assesses three areas:1) self-care (feeding, grooming, bathing, and dressing); 2) respiration and sphincter management and 3) mobility (bed and transfers and indoor/outdoor).
Number of items: 19
Procedure/Administration: Clinical staff scores the items based on the activities the patient is performing during the regular daily activities or as the patient reports in an interview.
How scored: Item scores are weighted related to the assumed clinical relevance. Scores are derived by adding up the items producing a total score (0 to 100) and/or subscale scores (self care: 0-20; respiration and sphincter management: 0-40; mobility 0-40).
Interpretability: Higher scores reflect higher levels of independence.
Acceptability: This is an SCI specific measure of basic functional independence.
Usability: Minimal staff/patient burden is required as the variables collected are important to patient care and reflect basic areas of patient concern.
Time to administer: 30-45 minutes to conduct and score.
Time to score: 30-45 minutes to conduct and score.
Training required: N/a
Availability: A copy of the SCIM III can be obtained from the article by Catz et al. (2007).
Equipment required: None
- The SCIM is quickly becoming one of the best research tools within the SCI population and has high clinical relevance for the rehabilitation for individuals with either traumatic/non-traumatic and complete/incomplete SCI.
- Ceiling and floor effects (especially floor) may be an issue for individuals at either who have very high or low level lesions.
IC/Inter O: Green light
Construct: Yellow light
Criterion: Green light
Note: TR= Test re-test; IC= Internal Consistency; Inter-O=Inter-observer; Intra-O=Intra-observer; SS=Sensitivity/Specificity; 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.
- Catz A, Itzkovich M, Agranov E, Ring H, Tamir A. SCIM--spinal cord independence measure: a new disability scale for patients with spinal cord lesions. Spinal Cord 1997;35:850-856.
- Catz A, Itzkovich M, Agranov E, Ring H, Tamir A. The spinal cord independence measure (SCIM): sensitivity to functional changes in subgroups of spinal cord lesion patients. Spinal Cord 2001a;39:97-100.
- Catz A, Itzkovich M, Steinberg F, Philo O, Ring H, Ronen J, Spasser R, Gepstein R, Tamir A. The Catz-Itzkovich SCIM: a revised version of the Spinal Cord Independence Measure. Disabil Rehabil 2001b;23:263-268.
- Catz A, Itzkovich M, Steinberg F, Philo O, Ring H, Ronen J, Spasser R, Gepstein R, Tamir A. Disability assessment by a single rater or a team: a comparative study with the Catz-Itzkovich spinal cord independence measure. J Rehabil Med 2002;34:226-230.
- Catz A, Goldin D, Fishel B, Ronen J, Bluvshtein V, Gelernter I. Recovery of neurologic function following nontraumatic spinal cord lesions in Israel. Spine 2004;29:2278-2282.
- Catz A, Greenberg E, Itzkovich M, Bluvshtein V, Ronen J, Gelernter I. A new instrument for outcome assessment in rehabilitation medicine: Spinal cord injury ability realization measurement index. Arch Phys Med Rehabil 2004;85:399-404.
- Catz A, Itzkovich M, Tesio L, Biering-SÃ¸rensen F, Weeks C, Laramee M, Craven BC, Tonack M, Hitzig SL, Glazer E, Zeilig G, Aito S, Scivoletto G, Mecci M, Chadwick RJ, El Masry WS, Osman A, Glass CA, Silva P, Soni BM, Gardner BP, Savic G, Bergstrom EM, Bluvshtein V, Ronen J. A multi-center International Study on the Spinal Cord Independence Measure, Version III: Rasch psychometric validation. Spinal Cord Resubmission requested 2006.
- Catz A, Itzkovich M, Tesio L, Biering-Sorensen F, Weeks C, Laramee MT, Craven BC, Tonack M, Hitzig SL, Glaser E, Zeilig G, Aito S, Scivoletto G, Mecci M, Chadwick RJ, El Masry WS, Osman A, Glass CA, Silva P, Soni BM, Gardner BP, Savic G, Bergstrom EM, Bluvshtein V, Ronen J. A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation. Spinal Cord 2007; 45: 275-291.
- Glass CA, Tesio L, Itzkovich M, Soni BM, Silva P, Mecci M, Chadwick R, et al. Spinal Cord Independence Measure, Version III: Applicability to the UK spinal cord injured population. J Rehabil Med 2009; 41: 723-728.
- Grijalva I, Guizar-Sahagun G, Castaneda-Hernandez G, Mino D, Maldonado-Julian H, Vidal-Cantu G, Ibarra A, Serra O, Salgado-Ceballos H, Arenas-Hernandez R. Efficacy and safety of 4-aminopyridine in patients with long-term spinal cord injury: a randomized, double-blind, placebo-controlled trial. Pharmacotherapy 2003;23:823-834.
- Itzkovich M, Tripolski M, Zeilig G, Ring H, Rosentul N, Ronen J, Spasser R, Gepstein R, Catz A. Rasch analysis of the Catz-Itzkovich spinal cord independence measure. Spinal Cord 2002;40:396-407.
- Itzkovich M, Tamir A, Philo O, Steinberg F, Ronen J, Spasser R, Gepstein R, Ring H, Catz A. Reliability of the Catz-Itzkovich Spinal Cord Independence Measure assessment by interview and comparison with observation. Am J Phys Med Rehabil 2003;82:267-272.
- Itzkovich M, Catz A, Biering-SÃ¸rensen F. SCIM III Reliability And Validity: A Multi-Center International Study. ISCoS Meeting Oct 2005 Munich, Germany Abs 34/8 http://www.iscos.org.uk/index.html Accessed May 2, 2006
- Jackson AB, Dijkers M, DeVivo MJ, Poczatek RB. A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. Arch Phys Med Rehabil 2004;85:1740-1748.
- McKinley WO, Seel RT, Gadi RK, Tewksbury MA. Nontraumatic vs. traumatic spinal cord injury: a rehabilitation outcome comparison. Am J Phys Med Rehabil 2001;80:693-699.
- Morganti B, Scivoletto G, Ditunno P, Ditunno JF, Molinari M. Walking Index for spinal cord injury (WISCI): criterion validation. Spinal Cord 2005;43:27-33.
- Popovic MR, Thrasher TA, Adams ME, Takes V, Zivanovic V, Tonack MI. Functional electrical therapy: retraining grasping in spinal cord injury. Spinal Cord 2006;44:143-151.
- Ronen J, Itzkovich M, Bluvshtein V, Thaleisnik M, Goldin D, Gelernter I, David R, Gepstein R, Catz A. Length of stay in hospital following spinal cord lesions in Israel. Spinal Cord 2004;42:353-358.
- Scivoletto G, Morganti B, Ditunno P, Ditunno JF, Molinari M. Effects on age on spinal cord lesion patients' rehabilitation. Spinal Cord 2003;41:457-464.
- van Hedel HJA, Dietz V, and the EM-SCI Study Group. Walking during daily life can be validly and responsively assessed in subjects with a spinal cord injury. Neurorehabil Neural Repair 2009; 23: 117-124.
- van Hedel HJA for the EMSCI Study Group. Gait speed in relation to categories of functional ambulation after spinal cord injury. Neural Repair 2009; 23(4): 343-350.