Reference Values and Cutoff Scores of the Spinal Cord Independence Measure III to Determine Independence for Wheelchair Users and Ambulatory Individuals With Spinal Cord Injury

Objective: To establish the reference values and optimal cutoff scores of the Spinal Cord Independence Measure Version III (SCIM III) to indicate independence of wheelchair users (WU) and ambulatory (AM) individuals with spinal cord injury (SCI).Design: A cross-sectional study.Setting: Tertiary rehabilitation center and communities. Participants: A total of 309 (168 WU and 141 AM) participants with SCI. Interventions: Not applicable. Main Outcome Measure(s): SCIM III scores.Results: Participants with greater levels of independence had significantly higher SCIM III scores, both total and subitem scores (P<.05). The SCIM III scores of >= 55 and >= 75 were optimal indicators of modified independence in WU and AM individuals, respectively (sensitivity and spec-ificity >93%, AUC>.95). In addition, scores of 90 were proved to be excellent indicators for independence of AM individuals (sensitivity 94%, specificity 100%, AUC=.99).Conclusions: The present findings provide the reference values of SCIM III scores covering WU and AM individuals with SCI at various levels of independence as well as optimal cutoff scores to indicate independence of these individuals. These data can be used as standard criteria for data comparison with patients' ability, and target functional values for individuals with SCI in clinical-, community-, and home-based settings. Archives of Physical Medicine and Rehabilitation 2023;104:83-9 (c) 2022 by the American Congress of Rehabilitation Medicine.