Craig Handicap Assessment & Reporting Technique (CHART)

# of studies reporting psychometric properties: 13

Interpretability

• Typical values:
  • Mean (SD) Scores for CHART:
    Physical Independence = 93 (12)
    Mobility = 77 (25.9)
    Occupation = 56.8 (39.6)
    Social Integration = 76.4 (24.7)
    Economic Self-Sufficiency = 75.5 (28.1)
    Total = 378.7 (86.8)
    (Tozato et al. 2005: Japanese version; n=293, n=246 males; chronic SCI)
  • Mean (SD) Scores for CHART-SF:
    Physical Independence = 47.0 (44.2)
    Cognitive Independence = 66.5 (36.4)
    Mobility = 69.6 (30.7)
    Occupation = 38.3 (39.4)
    Social Integration = 72.8 (35.2)
    Economic Self-Sufficiency = 38.4 (33.2)
    Total = 332.6 (145.8)
    (Gontkovsky et al. 2009: n=28; 21 males; 90% traumatic SCI; 68% incomplete, 32% complete; ASIA A-D; level of injury: cervical, thoracic, lumbar; chronic SCI)
• Total scores can be a misleading assessment of handicap, thus the use of subscales is recommended

MCID: not established for SCI
SEM: CHART SEM and MDC calculated from Tozato et al. 2005:

MDC: CHART MDC = 53.3 between Time 1 (6 weeks post-discharge from inpatient rehabilitation) and Time 2 (1 year post-discharge)

(De Wolf et al. 2010; n=58; 45 males; traumatic SCI; 25 paraplegia, 33 tetraplegia; ASIA A-D; data collected at 6 weeks and 1 year post-discharge from inpatient rehab)

Reliability

• Test re-test reliability is High (r = 0.87 to 0.93) for the CHART total score
• Proxy values are High or Moderate for all domains except cognitive independence (ICC = 0.34, ‘poor’ rating) for the CHART

(Whiteneck 1992; n=135; 113 males; 41 complete quadriplegia; 38 incomplete quadriplegia, 42 complete paraplegia, 14 incomplete paraplegia; 2-35 years post-injury living in the community)
(Cusick 2001; n=983 + their proxies; 560 males; SCI (n=224) and other disabilities, community living)
(Walker et al. 2003; N SCI = 236, 75% male)

• Low Internal Consistency for the CHART-SF:
  • Physical Independence: Cronbach’s alpha = 0.385
  • Mobility: Cronbach’s alpha = 0.236
  • Occupation: Cronbach’s alpha = 0.293
  • Cognitive Independence: Cronbach’s alpha = 0.562
  • Social Integration: Cronbach’s alpha = 0.351

(Golhasani-Keshtan et al. 2013; Persian version of CHART-SF; n=52; 52 males; mean age 49.3 years; 46 paraplegia, 6 tetraplegia)

Validity

• CHART domains and total score are able to differentiate groups based on:
  • Level of handicap
  • Gender
  • Age
  • Time since injury
• Domains social integration and economic self-sufficiency did not differentiate groups based on injury factors.
• Correlations between the CHART total score range from High for the SPRS (r=0.72) to Moderate for the CIM (r=0.47)
• Correlation between the CHART-SF total and the Community Integration Questionnaire (CIQ) is High (r=0.79)
• Significant sensitivity to change to the CHART was reported (P=.002) of 408.2±50.1 for Time 1, 431.6±57.4 for Time 2.

(De Wolf et al. 2010; n=58; 45 males; traumatic SCI; 25 paraplegia, 33 tetraplegia; ASIA A-D; data collected at 6 weeks and 1 year post-discharge from inpatient rehab)
(Dijkers 1999; n=2183, n=1766 males, n=417 females; records from the National SCI database)
(Hall et al. 1998; n=1998, 81.5% males; tetraplegia and paraplegia)
(Masedo et al. 2005; n=84; 67 males; level of injury: cervical, thoracic, and lumbar/sacral; mean time since injury (SD): 13.96 (9.36) years)
(Tozato et al. 2005: Japanese version; n=293, n=246 males; chronic SCI)
(Whiteneck 1992; n=135; 113 males; 41 complete quadriplegia; 38 incomplete quadriplegia, 42 complete paraplegia, 14 incomplete paraplegia; 2-35 years post-injury living in the community)

Responsiveness

No values were reported for the responsiveness of the CHART for the SCI population.

Floor/Ceiling Effect

• No floor effects reported for CHART or CHART-SF.
• Ceiling effects for CHART were reported only for the Social integration and Cognitive Independence subscales.

(De Wolf et al. 2010; n=58; 45 males; traumatic SCI; 25 paraplegia, 33 tetraplegia; ASIA A-D; data collected at 6 weeks and 1 year post-discharge from inpatient rehab)

Reviewers

Dr. Ben Mortenson, Tyra Chu, Dr. Carlos L. Cano-Herrera

Date Last Updated

31 December 2024