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Objective: This study aims to carry out the adaptation and cross-cultural validation of the SCIM IV assessment instrument in individuals with spinal cord injury. Methods: The process of cross-cultural adaptation took place in 7 stages: 1) initial translation, 2) committee composed of experts, 3) counter-translation, 4) synthesis of translations and linguistic analysis, 5) validation of the translation, 6) revision of the text and 7) test of the pre-final version of the SCIM IV questionnaire. For the psychometric evaluation, 100 individuals with spinal cord injuries were recruited. For the construct validity SCIM IV score was correlated with the score of the Functional Independence Measure (FIM). The exploratory factorial analysis was performed, the Kaiser-Meyer-Olkin index (KMO) was carried out to inform if the analysis is factored or not. For the criterion validity, the correlation of SCIM IV subscales with the motor FIM domains was performed. For internal consistency analysis, Cronbach's alpha was used. Reproducibility was analyzed through the Intraclass Correlation Coefficient (ICC), which analyzed intra and interobserver reliability. For responsiveness a measure was used that estimates the size of the effect denominated MRP. The correlation between the SCIM IV score and the AIS motor index was analyzed. The Pearson correlation coefficient was used to verify the correlations. Results: The instrument was not modified during the cross-cultural adaptation, with the same number of pages in portrait orientation, during the test of the pre-final version, health professionals did not report doubts. The correlation between a SCIM IV and a motor FIM, we obtained excellent ICC values (ρ = 0.86). The exploratory factorial analysis was calculated as appropriate (KMO = 0.87). In the validation of a criterion in the SCIM IV "self-care" and "mobility" subscales with the domains "selfcare", "mobility" and "locomotion" of the FIM we obtained an excellent agreement and the correlation between the subscale "respiration and sphincter control" from SCIM IV with the domain "control of sphincters" in the FIM, we obtained moderate agreement. As for Cronbach's alpha, the total SCIM IV result was considered within the expected (α = 0.91). A reliability analysis indicated good intra and inter-observer reproducibility. Responsiveness was low in chronic patients, but acute patients obtained a high responsiveness on the "self-care" subscale and moderate on the SCIM IV total. The correlation between an SCIM IV and the AIS motor index was considered moderate (ρ = 0.65). Conclusion: The cross-cultural adaptation of SCIM IV into Portuguese from Brazil, presented adequate psychometric indexes, guaranteeing the use of this instrument for the evaluation of functional independence in patients with spinal cord injury both clinical practice and research.

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Background: Etiologically, the risk of an ankle injury depends on extrinsic and intrinsic factors, such as muscle strength asymmetry, decreased flexibility, and decreased proprioception, as well as patient age and history of injuries. Purpose/Hypothesis: The purpose of this study was to identify risk factors present in the preseason assessment that may predispose professional soccer players to ankle injuries. We hypothesized that analysis of these parameters could relate the incidence of injuries to the deficits found during the preseason period, enabling the identification of risk factors to predict the occurrence of injuries. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 89 professional soccer athletes were evaluated in the preseason period; the evaluation included athlete history and anthropometric data collection, an isokinetic ankle evaluation, and functional tests: the Dorsiflexion Lunge Test and Y-Balance Test (YBT). The athletes were monitored during the competitive period, and the incidence of injuries was surveyed. The association of quantitative variables and injury outcomes was analyzed using the Student t test for independent samples, with P < .05. For the association of categorical variables and injury outcomes, the chi-square test was performed, with P < .05. Results: A higher incidence of ankle injuries was associated with lower YBT scores in the dominant ( P = .04) and nondominant ( P = .01) limbs. A higher body mass index was also associated with a higher injury occurrence ( P = .01). Conclusion: Functional tests, such as the YBT, are indicated tools for assessing the physical capacities and possible risks of ankle sprains, as they can evaluate the ankle functional capacity in a complex way, identifying athletes more prone to ankle injuries. Athletes’ body mass index should also be taken into account to prevent such injuries.

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