Spinal Cord Ability Ruler (SCAR)

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Tool Description:

The Spinal Cord Ability Ruler provides clinician-administered interval scale to measure volitional performance after SCI. The SCAR uses a combination of existent spinal cord injury measures and is administered by a clinician. Items were selected and adjusted from the ISNCSCI and SCIM, allowing for good measurement properties and a validated linear interval-level measure with repeatable precision across a broad range of SCI levels and severities.
The SCAR changes the scoring options for the various SCIM items so that there are less scale numbers, making it easier for the patient to differentiate from the various scoring options.


Available for free here: https://www.nature.com/articles/sc20171?proof=true

ICF Domain:

Body Function; Subcategory: Performance

Number of Items:

24 items

Brief Instructions for Administration and Scoring:

Volitional SCAR items were rated on a scale of 0 (complete dependence on assistance from others) to 3 (independence without devices), C5-C8 muscle contractions were scored from 0 (no muscle activity) to 2 (functional muscle activity)


MCID: not established for SCI
SEM: not established for SCI
MDC: not established for SCI



Measurement Property Summary:

# of studies reporting psychometric properties: 1


  • Internal consistency of the SCAR is High (α= 0.97)

[Reed et al. 2017]


No studies reporting validity data.


Not established in SCI.

Floor/ceiling effect:

Not established in SCI.


Dr. Bill Miller, Gita Manhas, Risa Fox

Date Last Updated:

August 3, 2020

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Equipment Needed

Reed R, Mehra M, Kirshblum S, Maier D, Lammertse D, Blight A, Rupp R, Jones L, Abel R, Weidner N; EMSCI Study Group; SCOPE, Curt A, Steeves J. Spinal cord ability ruler: an interval scale to measure volitional performance after spinal cord. Spinal Cord. 2017 Aug;55(8):730-738. injury.https://www.nature.com/articles/sc20171