Walking Index for Spinal Cord Injury (WISCI)

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).

Background on the WISCI Studies

At least 50% or more of individuals who survive a spinal cord injury will have incomplete injuries. This has been the experience of the Model SCI System Centers and that of the RSCICDV over the past 20 years. As many as 86% of persons with incomplete injuries to the cervical region have the potential to walk community distances (200 feet) at discharge. With new advances in drugs, training, and potential spinal cord transplantation in the future, more people with incomplete and complete injuries may gain this functional capacity.

In the past decade, multicenter clinical trials have shown promise by the demonstration of evidence-based outcomes to justify early intervention of drugs. However, some trials have been limited by the sensitivity of the scales used to evaluate the outcomes of these trials.

The WISCI scale, which was found to be valid and reliable, may demonstrate improvement of walking function in multicenter clinical trials because of increased sensitivity and precision. Such an outcome measure should have utility in current and future studies that evaluate pharmacological or medical rehabilitation interventions.To further evaluate the WISCI scale,the RSCICDV has embarked on a subsequent series of studies to further validate the WISCI as it applies to patients as they recover from SCI.

The Next Phase of WISCI Experiments

Current studies are demonstrating that the opinion of international experts is true when the WISCI is applied to patients recovering from SCI. Patients should improve on the WISCI scale as the strength in their lower extremities gets stronger (experiment 1).

Other studies are meant to show that the WISCI scale can measure how well subjects walk in regard to speed, distance and energy requirements (experiment 2).

Recently, the WISCI scale was shown to be responsive to change in a randomized clinical trial on body weight supported treadmill training (experiment 3). This means that as the patients improve in strength, speed of walking, and overall functional improvements, the WISCI scale also improves. This is very powerful because a blinded observer in multiple centers performed the WISCI and other assessments.

An important consumer/clinician study examining preference for recovery of function has provided interesting preliminary findings (experiment 4). Those who treat individuals with SCI actually rate function such as walking and wheelchair mobility differently than patients. Preliminary results from an international study suggest that the prioritization of walking preference shows cross-cultural differences among SCI rehabilitation professional personnel/staff.

WISCI Resources, Articles, and Posters.

Additional information, including resource materials which will help you use the WISCI in clinical studies may be found in other sections of this website.

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