The SCI-FAI assesses functional walking ability in ambulatory individuals with SCI (Field-Fote et al., 2001).
32
15-30 minutes
Adolescent
13 - 17
yearsAdult
18 - 64
yearsElderly Adult
65 +
yearsInitially reviewed by the Rehabilitation Measures Team in 2011; Updated by Jennifer H. Kahn, PT, DPT, NCS and the SCI EDGE task force of the Neurology Section of the APTA in 2012.
Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.
For detailed information about how recommendations were made, please visit: http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations
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Abbreviations: |
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HR |
Highly Recommend |
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R |
Recommend |
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LS / UR |
Reasonable to use, but limited study in target group / Unable to Recommend |
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NR |
Not Recommended |
Recommendations for use based on acuity level of the patient:
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Acute (CVA < 2 months post) (SCI < 1 month post) (Vestibular < 6 weeks post) |
Subacute (CVA 2 to 6 months) (SCI 3 to 6 months) |
Chronic (> 6 months) |
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SCI EDGE |
R |
R |
R |
Recommendations based on SCI AIS Classification:
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AIS A/B |
AIS C/D |
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SCI EDGE |
LS |
R |
Recommendations for entry-level physical therapy education and use in research:
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Students should learn to administer this tool? (Y/N) |
Students should be exposed to tool? (Y/N) |
Appropriate for use in intervention research studies? (Y/N) |
Is additional research warranted for this tool (Y/N) |
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SCI EDGE |
No |
No |
No |
Not reported |
Inter-rater reliability is adequate when using live scoring whereas inter-rater reliability is excellent when using video-taped scoring. Thus, use of video-taped scoring might yield more reliable scoring.
Ambulation Measures Review: (Lam et al, 2008; complied from data in Field-Fote et al, 2001)
Ambulation Measures Review: (Lam et al, 2008, compiled from data in Field-Fote et al, 2001)
*The SRD represents the smallest real clinical change beyond 0.
Acute SCI AIS-D Patients: (Lemay and Nadeau, 2010; n = 32, 15 paraplegia, 17 tetraplegia; mean age = 47.9 (12.8) years; time post lesion 77.2 (44.3) days; Limited sample size, so use with caution)
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SCI-FAI Norms |
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Scale |
Mean (SD) |
Range |
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SCI-FAI parameter (/20) |
18.5 (3.3) |
7–20 |
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Paraplegia |
17.8 (4.5) |
7–20 |
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Tetraplegia |
19.0 (1.8) |
14–20 |
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SCI-FAI assistive devices (/14) |
11.4 (2.7) |
7–14 |
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Paraplegia |
11.1 (2.4) |
7–14 |
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Tetraplegia |
11.8 (3.0) |
7–14 |
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SCI-FAI mobility (/5) |
3.7 (1.2) |
2–5 |
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Paraplegia |
3.4 (1.2) |
2–5 |
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Tetraplegia |
4 (1.1) |
2–5 |
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2MWT (m) |
109.3 (48.6) |
11-214 |
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Paraplegia |
101.3 (50) |
11-212 |
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Tetraplegia |
115.9 (48) |
43-214 |
Incomplete SCI : (Field-Fote et al, 2001; n = 22; mean age = 32; 4 raters scored each participant 3 times)
100% agreement among raters for the objective sections of the inventory (assistive device use and temporal distance measures).
Inter-rater reliability of the gait score, tested by comparing scores of the four raters obtained during a rating session;
Incomplete SCI: (Field-Fote et al, 2001)
Acute SCI AIS-D Patients : (Lemay and Nadeau, 2010)
Excellent Convergent validity with other measures of ability (see below)
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SCI-FAI Correlations with Clinical Assessments: |
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SCI-FAI gait parameter |
SCI-FAI assistive devices |
SCI-FAI mobility |
2MWT |
WISCI II |
10MWT |
TUG |
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BBS |
0.747** |
0.714** |
0.740** |
0.781** |
0.816** |
0.792** |
-0.815** |
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SCI-FAI gait parameter |
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0.609** |
0.716** |
0.805** |
0.761** |
0.777** |
-0.761** |
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SCI-FAI assistive devices |
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0.690** |
0.740** |
0.980** |
0.788** |
-0.802** |
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SCI-FAI mobility |
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0.688** |
0.630** |
0.756** |
-0.724** |
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2MWT |
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0.749** |
0.932^** |
-0.623^** |
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WISCI II |
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0.795** |
-0.799** |
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10MWT |
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-0.646^** |
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BBS = Berg Balance Scale 2MWT = 2-min walk test 10MWT = 10-m walk test SCI-FAI = Spinal Cord Injury Functional Ambulation Inventory TUG = Timed Up and Go WISCI II = Walking Index for Spinal Cord Injury |
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Incomplete SCI: (Field-Fote et al, 2001)
Incomplete SCI : (Field-Fote et al, 2001)
Incomplete SCI: (Field-Fote et al, 2001)
Ten physical therapists with at least 5 years of experience identified and ranked 6 parameters considered essential to walking performance for the gait score portion of the test. Item rankings were refined based on viewing of video taped walking sessions.
Acute SCI AIS-D Patients: (Lemay and Nadeau, 2010; n=32)
Ceiling effects were present on each section of the SCI-FAI (see table below). Percentage of patients tested who reach maximal scores:
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Patients reaching maximal scores on clinical assessments: |
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Scale |
Score |
% |
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SCI-FAI (gait parameter) |
20/20 |
68.8 |
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SCI-FAI (assistive devices) |
14/14 |
34.4 |
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SCI-FAI (walking mobility) |
5/5 |
34.4 |
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BBS |
56/56 |
37.5 |
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WISCI-II |
20/20 |
44.8 |
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SCI-FAI = Spinal Cord Injury Functional Ambulation Inventory BBS = Berg Balance Scale WISCI-II = Walking Index for Spinal Cord Injury |
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Incomplete SCI : (Field-Fote et al, 2001; n = 22; mean age = 32; 4 raters scored each participant 3 times)
Some evidence suggesting sensitivity: The change in the gait parameter scores following a walking focused rehabilitation program was 44.7%. Changes in gait speed and LEMS were correlated with the change in the gait parameter score.
Dawson, J., Shamley, D., et al. (2008). "A structured review of outcome measures used for the assessment of rehabilitation interventions for spinal cord injury." Spinal Cord 46(12): 768-780. Find it on PubMed
Field-Fote, E. C., Fluet, G. G., et al. (2001). "The spinal cord injury functional ambulation inventory (SCI-FAI)." Journal of Rehabilitation Medicine 33(4): 177-181. Find it on PubMed
Lam, T., Noonan, V., et al. (2007). "A systematic review of functional ambulation outcome measures in spinal cord injury." Spinal Cord 46(4): 246-254. Find it on PubMed
Lemay, J. and Nadeau, S. (2009). "Standing balance assessment in ASIA D paraplegic and tetraplegic participants: concurrent validity of the Berg Balance Scale." Spinal Cord 48(3): 245-250. Find it on PubMed
We have reviewed more than 500 instruments for use with a number of diagnoses including stroke, spinal cord injury and traumatic brain injury among several others.