• The Spinal Cord Ability Ruler provides clinician-administered interval scale to measure volitional performance after SCI. Specifically, it measures voluntary physical movements that contribute to independence in daily living including self-care, transfer and mobility items.
  • 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.

ICF Domain

Body Function ▶ Performance


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).

Number of Items

24 Items





Training Required

No advanced training required


Items are imbedded in “Spinal cord ability ruler: an interval scale to measure volitional performance after spinal cord injury” on page 734.

# of studies reporting psychometric properties: 1


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


Internal consistency of the SCAR is high (α = 0.97)

(Reed et al. 2017)


No studies reporting validity data


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

Floor/Ceiling Effect

  • Ceiling effects of 3%
  • Floor effects of 2.4% observed in the data set

(Reed et al. 2017)


Dr. Bill Miller, Gita Manhas, Risa Fox

Date Last Updated

3 August 2020

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