Spinal cord injury functional ambulation profile: a new measure of walking ability

Abstract

Background: Objective measures of functional walking remain scarce for individuals with incomplete spinal cord injury (ISCI). Hence, the authors developed the Spinal Cord Injury Functional Ambulation Profile (SCI-FAP), which encompasses the timed performance of 7 tasks, such as walking and negotiating obstacles, doors, and stairs.

Objective: To assess the reliability and validity of the SCI-FAP.

Methods: A total of 32 individuals with ISCI attended 2 testing sessions separated by 1 to 2 weeks. At the first session, participants performed the SCI-FAP, the 10-m walk test (10MW), the 6-minute walk test (6MW), and the Walking Index for Spinal Cord Injury (WISCI II); 3 raters scored the participants' performances on the SCI-FAP to assess interrater reliability. To establish convergent validity, SCI-FAP scores were compared with scores on the 10MW, 6MW, and WISCI II. At the second session, participants completed the SCI-FAP to assess test-retest reliability. To establish discriminative validity, SCI-FAP scores were compared between participants with ISCI and 60 able-bodied adults, who were scored on the SCI-FAP in a single session.

Results: Internal consistency (α = .95), interrater reliability (intraclass correlation coefficient [ICC] = 1.00), and test-retest reliability (ICC = 0.98) of the SCI-FAP were high. SCI-FAP scores were moderately correlated with results from the 10MW (r = -0.59), 6MW (r = -0.59), and WISCI II (M = -0.68). Performance on the SCI-FAP was significantly poorer among participants with ISCI compared with their able-bodied counterparts (P = .002).

Conclusions: The findings support the SCI-FAP as a valid and reliable measure of walking skill for individuals with ISCI.