Development, Content Validity and Reliability of Upper Extremity Functional Skill Measure in C5-C7 Spinal Cord Injury.

Abstract

A methodological research design. To create an objective measure for assessing hand functions in C5-C7 spinal cord injury (SCI) and estimation of its content validity and internal consistency reliability. This study was executed in three phases. Phase 1 included a thoroughreview of the literature, semi-structured in-depth interviews of participants with tetraplegiaand interviews of caregivers of SCI individualsand healthcare workers dealing with SCI to understand the hand functions of individuals with C5-C7 SCI. Phase 2 consisted of the development of the tool. The content validity ratio (CVR) method and the opinion of the expert validated the content of the upper extremity functional skill measure (UEFSM). Phase 3 included a quantitative evaluation of the tool which was done on a targeted group of 30 subjects with C5-C7 SCI. Through the review of the literature and in-depth interview of the participants, 11 items were developed under four content areas: grasp, grip, pinch and gross movement. Items with a minimum CVRof 0.56 were retained at a significance level of p = 0.05resulting in a 10-item toolfor assessing the hand function of individuals with C5-C7 SCI categorized under four subscales. Pilot testing on 10 subjects reveals an average time of 2 minutes and 25 seconds to complete the task. The Cronbach's alpha was found to be 0.878. UEFSM is a 10-item tool with good content validity and internal consistency reliability for the assessment of hand functions in individuals with C5-C7 SCI.