Spinal Cord Independency Measure (SCIM)

A disability scale  for patients with spinal cord lesions in order to make the functional assessments of patients with paraplegia or tetraplegia more sensitive to changes (Catz-1997, see references). The Spinal Cord Independence Measure (SCIM) is a comprehensive rating scale that measures the ability of patients with spinal cord lesions to perform everyday tasks according to their value for the patient.

The SCIM includes the following areas of function: self-care (subscore (0-20), respiration and sphincter management (0-40) and mobility (0-40). Each area is scored according to its proportional weight in these patients' general activity. The final score ranges from 0 to 100.

Development of SCIM started in 1994. Its first version was presented at the Atlanta American Spinal Injury Association (ASIA) International Society of Paraplegia meeting in 1996 and published in 1997. The SCIM has undergone two revisions (Catz-2001 and Catz-2007)  the most recent one resulting in the SCIM-III (Catz-2007) (see below).

AREA	SUBITEM	MAXIMAL SCORE
SELF-CARE	1. Feeding	3
	2A. Bathing upper body	3
	2B. Bathing lower body	3
	3A. Dressing upper body	4
	3B. Dressing lower body	4
	4. Grooming	3
Total score of area		20
RESPIRATION and SPHINCTER MANAGEMENT	5. Respiration	10
	6. Bladder management	15
	7. Bowel management	10
	8. Use of toilet	5
Total score of area		40
MOBILITY	9. Mobility in bed/action to prevent pressure sores	6
	10. Transfer bed-wheelchair	2
	11. Transfer wheelchair-toilet-tub	2
	12. Mobility indoors	8
	13. Mobility for moderate distances (10-100 m)	8
	14. Mobility outdoors (more than 100 meters)	8
	15. Stair management	3
	16. Transfer wheelchair-car	3
	17. Transfer ground-wheelchair	1
Total score of area		40
Total score of SCIM III		100

References

Catz A, Itzkovich M, Agranov E, Ring H, Tamir A. SCIM—Spinal Cord Independence Measure: A new disability scale for patients with spinal cord lesions. SpinalCord. 1997;35(12):850–56.

Catz A, Itzkovich M, Steinberg F, Philo O, Ring H, Ronen J, et al. The Catz-Itzkovich SCIM: a revised version of the Spinal Cord Independence Measure. Disabil Rehabil. 2001 Apr 15;23(6):263-8.

Catz A, Itzkovich M, Tesio L, Biering-Sorensen F, Weeks C, Laramee MT, et al. A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation. Spinal Cord. 2007 Apr;45(4):275-91.

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