Completed Research Studies

18. Title: Restoration of Walking after Spinal Cord Injury: Validation of the Walking Index for Spinal Cord Injury (WISCI 1) Scale for Hierarchial Ranking Experiment 1

Purpose: The purpose of this study is to determine whether the WISCI scale is valid and responsive to change in a clinical population of individuals during recovery from spinal cord injury and will follow a hierarchial ranking validated by experts in SCI. Also, to determine whether changes in lower extremity muscle strength correlates with the progression of walking recovery measured on the 20 level WISCI scale.

Principal Investigator: John F. Ditunno, MD
Co-Investigator(s): Anthony S. Burns, MD

Background: The initial Walking Index for Spinal Cord Injury (WISCI) study, published in 2000, is an international multicenter validity and reliability study developed in collaboration with members of the RSCICDV. A subsequent study by an international panel of SCI experts found the WISCI scale is 100% reliable and measures what it intends to measure (walking).

Although the WISCI scale has been validated by a group of experts, it needs further validation in a clinical setting to demonstrate the hierarchical ranking of its 20 levels for individuals recovering from SCI.

In this retrospective study of 103 persons with incomplete spinal cord injury (ISCI) from the RSCICDV, investigators examined recovery from the initial standing in the parallel bars to the maximum level achieved as long as one-to-two years post injury. In 94% of individuals, the progression was in one direction as described in the WISCI scale. In addition, correlation of American Spinal Injury Association (ASIA) grades with WISCI levels were significant at initial ambulation (p < .03) and at maximum recovery of walking function (p < .001). Initial ASIA grades and final WISCI levels correlated at (p < .001).

Although, these results demonstrate concurrent validity in a clinical setting, a prospective study needs to be performed. A prospective study will allow for testing of a large group of individuals for all 20 levels correlating the severity of the injury with the maximum level of walking function. In addition, the responsiveness of the scale to change and to interventions in clinical trials needs to be determined.

Status: Study Completed

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