Spinal Cord Injury Functional Ambulation Profile: A New Measure of Walking Ability

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 (alpha = .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.