• Self-report questionnaire that assesses an individual’s satisfaction with performance in life activities.
  • Assesses mobility, self-care, daily activity, recreational activity, and family roles
  • Developed based on interviews with clinicians, patients and their significant others

Clinical Considerations

Although the RNL is commonly used as part of the national reporting system for individuals with SCI, there has been very little research conducted on the psychometric properties for this patient population.

ICF Domain

Participation

Administration

  • Self-report or interviewer
  • Contains 11 items
  • There are 3 alternate scoring systems: a 10-point visual analogue scale, a 3-point scale, and a 4-point scale. We focus on the first scoring system here since it is most commonly used.  Each item is scored using a 10 cm visual analogue scale anchored with phrases (0 = no reintegration and 10 = complete reintegration).
  • Wheelchairs or other assistive/adaptive aids may be used when considering how to answer the questions.
  • Administration time is approximately 10 minutes.

Number of Items

11

Equipment

None

Scoring

  • Both the total score = sum (points all 11 items) and the adjusted score = (total score)/110 * 100 can be calculated.
  • A minimum adjusted score is 0 and a maximum adjusted score is 100.

Languages

English and French

Training Required

Does not require advanced training

Availability

Can be found here.

# of studies reporting psychometric properties: 3

Interpretability

  • No cut-points have been established for the SCI population.
  • Published data for the SCI population is available for comparison (see the Interpretability section of the Study Details sheet).

MCID: not established in SCI population
SEM: not established in SCI population
MDC: not established in SCI population

Reliability

  • Internal consistency of the RNL Index is High (Cronbach’s a=0.87)
  • Total item correlations ranged from 0.37-0.67

(Hitzig et al. 2012)

Validity

Correlation of the RNL Index is:

  • High with the Quality of Life Index (Pearson’s r=-0.654)
  • Moderate with the Functional Independence Measure (Pearson’s r=-0.348)
  • Moderate with the Rosenberg Self-Esteem Scale (Pearson’s r=-0.483)
  • Low with the American Spinal Injury Association (ASIA) – motor score (Pearson’s r=-0.196)

(Hitzig et al. 2012, May & Warren 2002, Gray et al. 2006)

Responsiveness

No values have been reported for the responsiveness of the RNL Index for the SCI population at this time.

Floor/Ceiling Effect

No values were reported for the presence of floor/ceiling effects in the RNL for the SCI population.

Reviewers

Dr. Ben Mortenson, John Zhu, Matthew Querée

Date Last Updated

16 Mar 2017

Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil 2012;93:108-14.
http://www.ncbi.nlm.nih.gov/pubmed/22200389

May LA, Warren S. Measuring quality of life of persons with spinal cord injury: external and structural validity. Spinal Cord 2002;40:341-350.
http://www.ncbi.nlm.nih.gov/pubmed/12080462

Gray DB, Hollingsworth HH, Stark SL, Morgan KA. Participation Survey/Mobility: psychometric properties of a measure of participation for people with mobility impairments and limitations. Arch Phys Med Rehabil 2006;87: 189-97.
http://www.ncbi.nlm.nih.gov/pubmed/16442971

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