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.

Languages: English

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

Summary:

• 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. 

Psychometric Summary:

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.

References

• 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.
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• Catz A, Itzkovich M, Tesio L, Biering-Sørensen 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.
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