Pilot study of reliability and validity of the Walking Index for Spinal Cord Injury II (WISCI-II) in children and adolescents with spinal cord injury.

OBJECTIVE: The objective of this study was twofold: 1) to evaluate the reliability of the Walking Index for Spinal Cord Injury II (WISCI-II) and Spinal Cord Independence Measure (SCIM) indoor mobility item (#12) when used with children with spinal cord injury (SCI) and 2) to examine the concurrent validity between the WISCI-II and the SCIM indoor mobility item in children with SCI. METHODS: A convenience sample of 10 children with SCI between 4-16 years of age was recruited to complete 2 videotaped trials of ambulation for 10 meters. Six licensed physical therapists trained in the use of the WISCI-II and SCIM served as raters; each rater independently scored the WISCI-II and SCIM indoor mobility item for each of the subjects' two trials by reviewing the videotape. The viewing and scoring of Trial 1 and Trial 2 were separated by at least 3 weeks. Inter- and intra-rater reliability was calculated using Intraclass Correlation Coefficients (ICC) and 95% Confidence Intervals (CI). Concurrent validity was evaluated using the Spearman Correlation Coefficient (r_{s}). RESULTS: Intra-rater and inter-rater reliability of repeated WISCI-II scores was high (ICC=0.98, CI=0.95-0.99; ICC=0.97, CI=0.96-0.99, respectively). Intra- and inter-rater reliability for the SCIM mobility score was equally high (ICC=0.96, CI=0.95-0.98, ICC=0.97, CI=0.95-0.98). There was strong correlation between WISCI-II scores and the SCIM indoor mobility item (r_{s}=0.99). CONCLUSION: In this sample of 10 children and six trained raters, intra- and inter-rater reliability of WISCI-II scores and the SCIM mobility indoors scores was high, providing preliminary indication for their utility with children. The high correlation between the WISCI-II and SCIM mobility item further supports concurrent validity.