Development, Validity, and Reliability of the Spinal Cord Injury Instrumental Activities of Daily Living Measure (SCI-IADLM)
Year: 2026
Type: article
Abstract: Background: Instrumental activities of daily living (IADLs) determine community participation and independence after spinal cord injury (SCI) but are seldom measured with culturally relevant, SCI-specific instruments in India. Objectives: To develop the Spinal Cord Injury Instrumental Activities of Daily Living Measure (SCI-IADLM) for adults with SCI in India and to examine its preliminary content validity, internal consistency, and reliability. Methods: This methodological instrument development study was conducted at the Indian Spinal Injuries Centre, Vasant Kunj, New Delhi. Item generation combined a focused literature review and semi-structured interviews with stakeholders ( n = 15). A 3-round content validation using Lawshe's method was conducted with 17 panellists (9 clinicians, 8 individuals with SCI). The final 33-item instrument was pilot-tested in 30 purposively sampled adults with SCI. Internal consistency (Cronbach's α), inter-item correlations, and “α if item deleted” analyses were performed. Scale-level content validity index (CVI) was computed. Reliability was calculated by item analysis and test-retest reliability. Results: The SCI-IADLM comprises 33 items across 12 domains including household management, community mobility, communication, financial management, and health management. All retained items exceeded the Lawshe content validity ratio (CVR) threshold for N = 17 (CVR ≥ 0.529); scale-level CVI = 1.00. Pilot testing ( n = 30) yielded Cronbach's α = 0.857. Inter-item correlations ranged from −0.426 to 0.852. Deletion of items 4 (care of pets) or 24 (educational participation) would minimally increase α to 0.865; these items were retained for theoretical importance. Participant feedback indicated clarity and acceptability. Test-retest reliability analysis demonstrated high preliminary stability, with an intraclass correlation coefficient (ICC) of 1.00 (95% confidence interval: lower bound 0.99, upper bound 1.00) in the pilot sample. Conclusion: The SCI-IADLM demonstrates strong preliminary content validity and good internal consistency in a pilot sample of adults with SCI in India. Further large-scale multisite psychometric validation (test-retest reliability, factor structure/Rasch analysis, responsiveness, and cross-linguistic adaptation) is necessary.
DOI: 10.46292/sci25-00139
Authors: Twinkle Luthra, Ishmeet Singh, Lipika Malik
Language: English
Topic: Spinal Cord Injury Research
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7214915519