COSMIN database

A systematic review of functional ambulation outcome measures in spinal cord injury

Lam, T., Noonan, V. K., Eng, J. J., and Team, Scire Research
STUDY DESIGN: Systematic review.

OBJECTIVES: To systematically review the psychometric properties of outcome measures used to assess ambulation in people with spinal cord injury (SCI).

SETTING: Vancouver, BC, Canada.

METHODS: A keyword literature search of original articles that evaluated the psychometric properties of ambulation outcome measures in the SCI population was conducted using multiple databases. Multidimensional scales of function were included if specific data were available on ambulation-related subscales. Reliability, validity and responsiveness values were extracted and conclusions drawn about the psychometric quality of each measure.

RESULTS: Seven outcome measures were identified and were broadly categorized into timed and categorical measures of ambulation. Timed measures included timed walking tests that showed excellent reliability, construct validity and responsiveness to change. The psychometric properties of the categorical scales were more variable, but those that were developed specifically for the SCI population had excellent reliability and validity. Categorical scales also exhibited some floor or ceiling effects.

CONCLUSION: Excellent tools are available for measuring functional ambulation capacity. Further work is required to develop and evaluate outcome measures to include environmental factors that contribute to the ability to achieve safe, functional ambulation in everyday settings.
Spinal Cord
1362-4393 (Print)
Publication year:
Functional status:
Physical functioning
Adults (18-65)
Children (0-18)
Seniors (65+)
Injury, poisoning and certain other consequences of external causes
PRO / non-PRO:
Non-patient Reported Outcome
Patient Reported Outcome
Type of measurement instrument:
4 - Performance-based tests
6 - Clinical rating scales
7 - Observations
10MWT - 10 Meter Walk Test   
6MWT - 6-Minute Walk Test    | 
FIM - Functional Independence Measure (Also modified version exists)
SCI-FAI - Spinal Cord Injury Functional Ambulation Inventory
SCIM - Spinal Cord Independence Measure
TUG - Timed Up and Go test   
WISCI - Walking Index for Spinal Cord Injury