Development and validation of the Italian version of the Spinal Cord Independence Measure III.
PURPOSE
To provide a translation and cultural adaptation of the Spinal Cord Independence Measure version III scale for Italy (i-SCIM3) and to validate this version of the scale.


METHOD
i-SCIM3 was developed involving a forward-backward translation and administered to patients with spinal cord lesions (SCL) admitted to two centers. Two raters for each center evaluated patients at admission and discharge. Psychometric testing included reliability by internal consistency (Cronbach's alpha) and test-retest reliability. The validity of i-SCIM3 was assessed by comparing it with the Italian version of Functional Independence Measure (FIM).


RESULTS
One hundred three adult patients with SCL (84 males) with a mean age of 50.33+/-15.35 years were recruited. Seventy-four patients were paraplegic and 29 patients were tetraplegic. The median time elapsed between the two evaluations was 77.5 days (interquartile range, 53-144 days). Internal consistency, inter-rater reliability, and test-retest reliability were satisfactory overall, showing values higher than 0.90. The validity of i-SCIM3 was confirmed by the close correlation with FIM results both at admission and discharge (r=0.91, p<0.01). The sensitivity to change of i-SCIM3 was similar to that of FIM.


CONCLUSION
i-SCIM3 was found to be a consistent, reliable, and valid scale for use in the clinical setting. It is the first validated scale in Italian for patients with SCL.