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Citation |
Tulsky DS, Jette A, Kisala PA, Kalpakjian C, Dijkers MP, Whiteneck GG, Ni P, Kirshblum S, Charlifue S, Heinemann AW, Forchheimer M, Slavin M, Houlihan B, Tate D, Dyson-Hudson TA, Fyffe D, Williams S, Zanca JM. Arch. Phys. Med. Rehabil. 2012; 93(10): 1722-1732. |
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Affiliation |
Department of Physical Medicine and Rehabilitation, University of Michigan Medical School, Ann Arbor, MI. |
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Copyright |
(Copyright © 2012, Elsevier Publishing) |
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DOI |
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PMID |
22609299 |
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Abstract |
OBJECTIVE: To develop a comprehensive set of patient reported items to assess multiple aspects of physical functioning relevant to the lives of people with spinal cord injury (SCI) and to evaluate the underlying structure of physical functioning. DESIGN: Cross-sectional SETTING: Inpatient and community PARTICIPANTS: Item pools of physical functioning were developed, refined and field tested in a large sample of 855 individuals with traumatic spinal cord injury stratified by diagnosis, severity, and time since injury INTERVENTIONS: None MAIN OUTCOME MEASURE: SCI-FI measurement system RESULTS: Confirmatory factor analysis (CFA) indicated that a 5-factor model, including basic mobility, ambulation, wheelchair mobility, self care, and fine motor, had the best model fit and was most closely aligned conceptually with feedback received from individuals with SCI and SCI clinicians. When just the items making up basic mobility were tested in CFA, the fit statistics indicate strong support for a unidimensional model. Similar results were demonstrated for each of the other four factors indicating unidimensional models. CONCLUSIONS: Though unidimensional or 2-factor (mobility and upper extremity) models of physical functioning make up outcomes measures in the general population, the underlying structure of physical function in SCI is more complex. A 5-factor solution allows for comprehensive assessment of key domain areas of physical functioning. These results informed the structure and development of the SCI-FI measurement system of physical functioning. Language: en |