Study design: A formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed. Objectives: The objective of the study was to report on the results of the consensus process to develop the first version of a Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set, and a Brief ICF Core Set for individuals with spinal cord injury (SCI) in the long-term context. Setting: The consensus conference took place in Switzerland. Preparatory studies were performed worldwide. Methods: Preparatory studies included an expert survey, a systematic literature review, a qualitative study and empirical data collection involving people with SCI. Relevant ICF categories were identified in a formal consensus process by international experts from different backgrounds. Results: The preparatory studies identified a set of 595 ICF categories at the second, third or fourth level. A total of 34 experts from 31 countries attended the consensus conference (12 physicians, 6 physical therapists, 5 occupational therapists, 6 nurses, 3 psychologists and 2 social workers). Altogether, 168 second-, third-or fourth-level categories were included in the Comprehensive ICF Core with 44 categories from body functions, 19 from body structures, 64 from activities and participation and 41 from environmental factors. The Brief Core Set included a total of 33 second-level categories with 9 on body functions, 4 on body structures, 11 on activities and participation and 9 on environmental factors. Conclusion: A formal consensus process integrating evidence and expert opinion based on the ICF led to the definition of the ICF Core Sets for individuals with SCI in the long-term context. Further validation of this first version is needed.

Study design: Cross-sectional validation study. Objectives: To develop and validate a self-report version of the Spinal Cord Independence Measure (SCIM III). Setting: Two SCI rehabilitation facilities in Switzerland. Methods: SCIM III comprises 19 questions on daily tasks with a total score between 0 and 100 and subscales for 'self-care', 'respiration & sphincter management' and 'mobility'. A self-report version (SCIM-SR) was developed by expert discussions and pretests in individuals with spinal cord injury (SCI) using a German translation. A convenience sample of 99 inpatients with SCI was recruited. SCIM-SR data were analyzed together with SCIM III data obtained from attending health professionals. Results: High correlations between SCIM III and SCIM-SR were observed. Pearson's r for the total score was 0.87 (95% confidence interval ( INTRODUCTIONThe Spinal Cord Independence Measure (SCIM), which was first published in 1997, 1 has become a widely used instrument to measure functioning in activities of daily living in persons with spinal cord injury (SCI). 2 Its main advantages over other instruments used for functional assessment in rehabilitation medicine are its sensitivity to changes in performance of tasks that are relevant for SCI patients, and the fact that it measures not only the burden of care, but also achievements, which have medical, psychological or social relevance for the SCI patient. The third version of the instrument, SCIM III, has been tested for validity and reliability in multicenter studies with satisfying psychometric properties. [3][4][5] SCIM III comprises items on 19 daily tasks grouped into three subscales. Item scores are weighted according to their clinical relevance and are graded for increasing difficulty, that is, requiring higher ability of the person with SCI. Each item has between 2 and 9 grades. The total SCIM III score ranges between 0 and 100, higher scores reflecting higher levels of performance or independence of a person. 3 The three subscales assess the areas of 'self-care' (six items, range 0-20), 'respiration & sphincter management' (four items, range 0-40) and 'mobility' (nine items, range 0-40).SCIM III is scored in observation of persons with SCI by health professionals. Ideally, each subscale is scored by clinical staff experienced in the assessment of the activities covered by the subscale. Such observations are time consuming and mainly applicable in inpatient settings. 6 In the outpatient setting, SCIM III data were collected by a single rater or in interviews previously, although with slightly decreased precision. 7,8 For research purposes, SCIM data are obtained by interview as part of the regular follow-up of large international studies, such as the European Multicenter Study about Spinal Cord Injury (EMSCI). 9 Studies conducted in the SCI community usually rely on selfadministered questionnaires for data collection. This method requires comparatively few resources, provides fast data collection and is applicable independent of the setting. 6,10 Using...

Study design: A formal decision-making and consensus process integrating evidence gathered from preparatory studies was followed. Objectives: The aim of this study was to report on the results of the consensus process to develop the first version of a Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set and a Brief ICF Core Set for individuals with spinal cord injury (SCI) in the early post-acute context. Setting: The consensus conference took place in Switzerland. Preparatory studies were performed worldwide. Methods: Preparatory studies included an expert survey, a systematic literature review, a qualitative study and empirical data collection involving people with SCI. ICF categories were identified in a formal consensus process by international experts from different backgrounds. Results: The preparatory studies identified a set of 531 ICF categories at the second, third and fourth levels. From 30 countries, 33 SCI experts attended the consensus conference (11 physicians, 6 physical therapists, 5 occupational therapists, 6 nurses, 3 psychologists and 2 social workers). Altogether 162 second-, third-or fourth-level categories were included in the Comprehensive ICF Core Sets with 63 categories from the component Body Functions, 14 from Body Structures, 53 from Activities and Participation and 32 from Environmental Factors. The Brief Core Set included a total of 25 second-level categories with 8 on Body Functions, 3 on Body Structures, 9 on Activities and Participation, and 5 on Environmental Factors.

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