The WISCI is a measure of ambulation designed specifically for SCI clinical trials (Ditunno et al. 2000). The WISCI evaluates the amount of physical assistance, braces or devices required to walk 10 metres. 

Number of items: N/a

Procedure/Administration: The client walks 10 meters – this distance represents household ambulation.

How scored: The clinician observes walking and rates the level which the person is considered safe. A score from 0 to 20 is assigned. Level 0: “patient is unable to stand and/or participate in walking” to level 20: “ambulates with no devices, with brace and no assistance”.

Interpretability: No normative data or cut scores are available but the WISCI is gaining popularity and comparisons can be made with existing studies. Scores are self evident.

Acceptability: The WISCI is an SCI specific test. It covers the entire range of walking ability.

Languages: English

Usability: A score is possible even if the individual cannot walk 10m. However, because the furthest walk distance is 10m, it would not be suitable for individuals with minor impairments

Time to administer: Varies between subjects.

Time to score: Minimal.

Training required: Training beyond knowledge of ambulation is not required. Scoring definitions provided are clear.

Availability: N/a

Equipment required: Equipment is typically available in the clinical setting: 5 meter parallel bars and walking devices (e.g. braces, cane, walker).

Summary:

• The WISCI levels are relevant to individuals with SCI. There is no additional burden is as the test falls into typical clinical practice parameters.  Administration time is.
• It would be a useful to incorporate the WISCI into clinical practice and to evaluate new SCI therapies.  Additional tests may be necessary to assess endurance (e.g. 6MWT) and/or walking speed (eg.10MWT), especially for individuals with greater walking capacity.

Psychometric Summary

Note: TR= Test re-test; IC= Internal Consistency; Inter-O=Inter-observer; Intra-O=Intra-observer; SS=Sensitivity/Specificity.

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.

N/a= No information.

References

• Ditunno JF, Ditunno PL, Graziani V, Scivoletto G, Bernardi M, Castellano V, Marchetti M, Barbeau H Frankel HL D'Andrea Greve JM, Ko HY, Marshall R, Nance P. Walking index for spinal cord injury (WISCI): an international multicenter validity and reliability study. Spinal Cord 2000;38:234-243.
• Dittuno PL Dittuno JF. Walking index for spinal cord injury (WISCI II): scale revision. Spinal Cord 2001;39:654-656.
• Ditunno JF, Burns AS, Marino RJ. 2005. Neurological and functional capacity outcome measures: essential to spinal cord injury clinical trials. J Rehab Res Dev 2005;42(Suppl 1): 35-41.
• Ditunno JF, Scivoletto G, Patrick M, Biering-Sorensen F, Abel R, Marino R. Validation of the walking index for spinal cord injury in a US and European clinical population. Spinal Cord 2008; 46: 181-188.
• 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.
• van Hedel HJA Wirz M, Dietz V. Assessing walking ability in subjects with spinal cord injury: validity and reliability of 3 walking tests. Arch Phys Med Rehabil 2005;86:190-196.