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  2. Quadriplegia Index of Function – Short Form

Quadriplegia Index of Function – Short Form

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Purpose

Assesses ADLs performed with the hands among non-ambulatory individuals with cervical SCI in a format that is less redundant and easier to administer and score than the Quadriplegia Index of Function (QIF).

Link to Instrument

Instrument Details

Acronym SF-QIF

Cost

Free

Diagnosis/Conditions

  • Spinal Cord Injury

Populations

Spinal Injuries

Key Descriptions

  • The SF-QIF contains 6 items assessing the following ADLs via interview:
    1) Transfers
    2) Grooming
    3) Bed mobility
    4) Dressing
    5) Feeding
    6) Wheelchair management
  • Items are scored on a 5-point scale based on assistance required to complete the task with scores ranging 0 (Dependent) to 4 (Independent).
  • The maximum score is 24 points with no weighted system for scoring.

Number of Items

6

Time to Administer

5-10 minutes

Required Training

No Training

Instrument Reviewers

Initially reviewed by Eileen Tseng, PT, DPT, NCS, Rachel Tappan, PT, NCS, and the SCI EDGE task force of the Neurology Section of the APTA in 4/2012  

ICF Domain

Activity

Professional Association Recommendation

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 (Vestibular EDGE) 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:  

 

Abbreviations:

 

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations based on SCI AIS Classification: 

 

AIS A/B

AIS C/D

SCI EDGE

NR

NR

 

Recommendations for entry-level physical therapy education and use in research:

 

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)

SCI EDGE

No

No

Yes

Not reported

Considerations

  • The SF-QIF may be limited in distinguishing between individuals with C7 and C8 level of lesions (Marino & Goin 1999)

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Spinal Injuries

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Normative Data

Chronic SCI:

(Snoek, et al, 2008; n = 47 individuals with tetraplegia; mean age = 42 (±13) years; mean time since injury = 11 (±9) years; 44% with AIS A 31% with AIS B, 9% with AIS C, and 16% with AIS D)

  • For best motor level complete lesions C6 and above (n = 23), mean score: 9.9 ±6.9
  • For best motor level incomplete lesions and/or best motor level below C6 (n = 24), mean score 19 ±6.1

Internal Consistency

Subacute SCI:

(Marino & Goin, 1999; n = 95 individuals with tetraplegia; mean age = 31.2 (± 13.2) years; time since injury > 6 months; n = 57 with Frankel A, n = 19 with Frankel B, n = 7 with Frankel C, and n = 12 with Frankel D)

  • Excellent internal consistency (Cronbach’s alpha = 0.89)

Criterion Validity (Predictive/Concurrent)

Subacute SCI:

(Marino & Goin, 1999)

  • Excellent correlation between the SF-QIF and the QIF (r = 0.987)
  • Excellent correlation between the SF-QIF and the Upper Extremity Motor Score (UEMS) (Spearman’s r = 0.824)

Construct Validity

Chronic SCI:

(Snoek, et al., 2008)

  • Adequate correlation between SF-QIF scores and health state related to upper-extremity impairment of subjects with tetraplegia (Spearman’s r = 0.313; p = 0.03)

Content Validity

Tetraplegia:

(Marino & Goin 1999)

 

  • The SF-QIF was developed from the full version of the QIF which has been well-validated
  • Items to be included in the SF-QIF were determined using regression analysis to determine which items of the QIF would best predict the outcome of the full version of the QIF
  • The six items included in the SF-QIF explained 99% of the variance in total QIF scores

Floor/Ceiling Effects

Subacute SCI:

(Marino & Goin, 1999)

  • Possible ceiling effect for individuals with low level tetraplegia, i.e. T1 level of lesion

Responsiveness

SCI:

(Spooren et al, 2006; n = 60 individuals with tetraplegia; mean age = 38.9 (range = 13.42-64.5) years; n = 42 individuals with C3-C6 level of injury; n = 18 individuals with C7-T1 level of injury)

  • Poor correlation between responsiveness Van Lieshout Test (VLT) and SF-QIF (Spearman’s r = 0.194) 
  • Excellent correlation between responsiveness of the FIM and SF-QIF (Spearman’s r = 0.714)
  • Large change in SF-QIF score in people with tetraplegia from rehabilitation admission to 3 months later for total group (Effect Size (ES) = 1.38), AIS A-B (ES = 1.59), AIS C-D (ES = 1.57), C3-C6 level of injury (ES = 1.05), and C7-T1 level of injury (ES = 2.22)
  • Large change in SF-QIF score in people with tetraplegia from rehabilitation admission to rehabilitation discharge (mean 288 days) for total group (ES = 2.18), AIS A-B (ES = 2.81), AIS C-D (ES = 2.04), C3-C6 level of injury (ES = 1.61), and C7-T1 level of injury (ES = 3.26) 
  • Moderate change in SF-QIF score in people with tetraplegia from 3 months post-rehabilitation admission to rehabilitation discharge for total group (ES = 0.4), AIS A-B (ES = 0.52), AIS C-D (ES = 0.35), C3-C6 level of injury (ES = 0.34), and C7-T1 level of injury (ES = 0.6)

Bibliography

Marino, R. J. and Goin, J. E. (1999). "Development of a short-form Quadriplegia Index of Function scale." Spinal Cord 37(4): 289-296. 

Snoek, G. J., IJzerman, M. J., et al. (2005). "Choice-based evaluation for the improvement of upper-extremity function compared with other impairments in tetraplegia." Archives of physical medicine and rehabilitation 86(8): 1623-1630. 

Spooren, A. I., Janssen-Potten, Y. J., et al. (2006). "Measuring change in arm hand skilled performance in persons with a cervical spinal cord injury: responsiveness of the Van Lieshout Test." Spinal Cord 44(12): 772-779. 

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