PMID- 28084060 OWN - NLM STAT- MEDLINE DCOM- 20180611 LR - 20191210 IS - 1973-9095 (Electronic) IS - 1973-9087 (Linking) VI - 53 IP - 4 DP - 2017 Aug TI - What do spinal cord injury patients think of their improvement? A study of the minimal clinically important difference of the Spinal Cord Independence Measure III. PG - 508-515 LID - 10.23736/S1973-9087.17.04240-X [doi] AB - BACKGROUND: The Spinal Cord Independence Measure (SCIM III) is a scale of independence in the activities of daily life, specifically designed for spinal cord injury subjects. AIM: The aim of this study was to calculate the minimal clinically important difference (MCID) of the SCIM III according to distribution and anchor based approach. DESIGN: Prospective study. SETTING: Four Spinal Cord Units in Italy. POPULATION: Patients with acute/subacute spinal cord injury/lesion. METHODS: The scores of the total SCIM and of the four subscale was recorded at admission and discharge. Clinical significance was calculated according to anchor based methodology using a global rating of change questionnaire. The accuracy of MCID values in predicting a judgment of small improvement by the patients has been assessed by means of the area under the receiving operating curves (aROC). RESULTS: Total SCIM MCID values varied from 12 for patients with complete tetraplegia to 45.3 for those with incomplete thoracic lesions. The MCID of self-care varied from 3.3 to 8.5 and from 10 to 18 for respiration and sphincter management, depending on the level and severity of the lesion. With regard to mobility (room and toilet), the MCID varied from 1 to 3 and from 2.5 to 7.26 for mobility (indoors and outdoors). The aROC was between good and excellent for all these values. CONCLUSIONS: The results provide benchmarks for clinicians and researchers to interpret whether patients' change score on the SCIM III can be interpreted as true or clinically meaningful and to make clinical judgments about the patients' progress. CLINICAL REHABILITATION IMPACT: Our data could be useful for both clinicians and researchers. At the beginning of rehabilitation clinicians may have an idea of the minimal improvement of the patient (based on his neurological status) that could have an impact on patient's life. At the end of rehabilitation process, it is possible to control if the patient achieved an improvement that is true and significant. Researchers could also use these criteria to evaluate the clinical significance of an intervention by calculating the number of subjects in the treatment and control groups (or in two different treatment groups) who achieved a change calculated as the natural recovery plus the MCID. FAU - Corallo, Viviana AU - Corallo V AD - Physical Medicine and Rehabilitation Residency Department, University of Catania, Catania, Italy. AD - Spinal Cord Unit, Cannizzaro Hospital, Catania, Italy. FAU - Torre, Monica AU - Torre M AD - Spinal Cord Unit, IRCCS S. Lucia Foundation, Rome, Italy. AD - Spinal Research (SpiRe) Laboratory, IRCCS S. Lucia Foundation, Rome, Italy. FAU - Ferrara, Giovanna AU - Ferrara G AD - Spinal Cord Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy. FAU - Guerra, Federica AU - Guerra F AD - Spinal Cord Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy. FAU - Nicosia, Gabriella AU - Nicosia G AD - Spinal Cord Unit, Cannizzaro Hospital, Catania, Italy. FAU - Romanelli, Ersilia AU - Romanelli E AD - Spinal Cord Unit, Bari University Policlinic, Bari, Italy. FAU - Lopopolo, Angela AU - Lopopolo A AD - Spinal Cord Unit, Bari University Policlinic, Bari, Italy. FAU - Onesta, Maria P AU - Onesta MP AD - Spinal Cord Unit, Cannizzaro Hospital, Catania, Italy. FAU - Fiore, Pietro AU - Fiore P AD - Spinal Cord Unit, Bari University Policlinic, Bari, Italy. FAU - Falcone, Roberta AU - Falcone R AD - Statistics Faculty, Bologna University, Bologna, Italy. FAU - Bonavita, Jacopo AU - Bonavita J AD - Spinal Cord Unit, Montecatone Rehabilitation Institute, Imola, Bologna, Italy. FAU - Molinari, Marco AU - Molinari M AD - Spinal Cord Unit, IRCCS S. Lucia Foundation, Rome, Italy. AD - Spinal Research (SpiRe) Laboratory, IRCCS S. Lucia Foundation, Rome, Italy. FAU - Scivoletto, Giorgio AU - Scivoletto G AD - Spinal Cord Unit, IRCCS S. Lucia Foundation, Rome, Italy - g.scivoletto@hsantalucia.it. AD - Spinal Research (SpiRe) Laboratory, IRCCS S. Lucia Foundation, Rome, Italy. LA - eng PT - Evaluation Study PT - Journal Article PT - Multicenter Study DEP - 20170112 PL - Italy TA - Eur J Phys Rehabil Med JT - European journal of physical and rehabilitation medicine JID - 101465662 SB - IM MH - *Activities of Daily Living MH - Adult MH - Aged MH - Cohort Studies MH - *Disability Evaluation MH - Female MH - Humans MH - Injury Severity Score MH - Italy MH - Male MH - Middle Aged MH - *Minimal Clinically Important Difference MH - Paraplegia/rehabilitation MH - Patient Satisfaction MH - Physical Therapy Modalities MH - Prospective Studies MH - Quadriplegia/rehabilitation MH - ROC Curve MH - Recovery of Function MH - Rehabilitation Centers MH - Spinal Cord Injuries/*diagnosis/*rehabilitation MH - Treatment Outcome EDAT- 2017/01/14 06:00 MHDA- 2018/06/12 06:00 CRDT- 2017/01/14 06:00 PHST- 2017/01/14 06:00 [pubmed] PHST- 2018/06/12 06:00 [medline] PHST- 2017/01/14 06:00 [entrez] AID - S1973-9087.17.04240-X [pii] AID - 10.23736/S1973-9087.17.04240-X [doi] PST - ppublish SO - Eur J Phys Rehabil Med. 2017 Aug;53(4):508-515. doi: 10.23736/S1973-9087.17.04240-X. Epub 2017 Jan 12.