• The Spinal Cord Injury-Falls Concern Scale (SCI-FCS) is a self-report scale assessing the level of concern about falling during common activities of daily life in people with spinal cord injuries who are dependent on manual wheelchairs.
  • Lower scores indicated fewer fall concerns.

ICF Domain

Activity ▶ Participation

Administration

  • Items rated 1-4
  • Total score (16-64) is sum of all items
  • Higher scores indicate greater levels of fall concern

Number of Items

16 items

Equipment

None

Languages

English, Turkish, Brazilian Portuguese, Thai, Italian, Swedish, and Norwegian.

Training Required

Does not require advanced training

Availability

The Spinal Cord Injury-Falls Concern Scale worksheet can be found here.

# of studies reporting psychometric properties: 7

Interpretability

MCID: not established in SCI population
SEM: 2.6 (12%)
MDC: 7.1

(Roaldsen et al. 2015: n=54; 45 males, 9 females; complete and incomplete injury; 9 cervical, 18 thoracic, and 5 lumbar-sacral; median (IQR) time since injury: 13 (6-30) years; Norwegian version)

Typical Values:

  • Median (range) score = 21 (16-64)

(Butler Forslund et al. 2016: n=87; 65 males; 45 cervical, 27 thoracic, 5 lumbar; 53 ASIA A, 18 ASIA B, 9 ASIA C, 6 ASIA D; median (range) time since injury: 15 (2-52) years; Swedish version)

Reliability

  • High Test-retest Reliability: ICC = 0.81-0.99
  • High Internal Consistency: α =0.82-0.92

(Boswell-Ruys et al. 2010; mean 3.5 days interval, N=20 with SCI, 14 males, mixed injury types, community and hospitals, mean (SD) time since injury = 15 (15) years)
(Marquez et al. 2018, n=124; 100 males; mean (SD) age: 46.2 (15.0) years; 93 Paraplegia, 61 Complete Paraplegia, 31 Tetraplegia, 21 Complete Tetraplegia, 35 Acute spinal cord injury)
(Basak & Duman 2024, n=134; 95 males; 39 females; mean age 39.26, various levels of injury; Turkish version)
(Galante-Maia et al. 2021; n=130; Brazilian Portuguese version)
(Pramodhyakui & Pramodhyakui 2020, n=52, 44 males, 10 females; 11 ASIA C, 2 ASIA D; Thai version)

Validity

  • Moderate Correlation the Wheelchair Use Confidence Scale, Short Form: r = 0.56

(Marquez et al. 2018, n=124; 100 males; mean (SD) age: 46.2 (15.0) years; 93 Paraplegia, 61 Complete Paraplegia, 31 Tetraplegia, 21 Complete Tetraplegia, 35 Acute spinal cord injury; Italian version)

  • High Correlation with FES-I Scale: r = 0.97

(Basak & Duman 2024, n=134; 95 males; 39 females; mean age 39.26, various levels of injury; Turkish version)

Responsiveness

Not established in SCI

Floor/Ceiling Effect

13 participants (16%) scored the lowest possible (16/64), while only 1 scored the maximum (64/64)

(Butler Forslund et al. 2016)

Reviewers

Dr. Vanessa Noonan, Dr. Carlos L. Cano-Herrera

Date Last Updated

31 December 2024

Basak T, Duman S. Cross-cultural adaptation, reliability, and validity study of the Turkish version of the “Spinal Cord Injury-Falls Concern Scale”. Disabil Rehabil. 2024; 46(22):5387-5394
https://pubmed.ncbi.nlm.nih.gov/38285882/

Boswell-ruys CL, Harvey LA, Delbaere K, Lord SR. A Falls Concern Scale for people with spinal cord injury (SCI-FCS). Spinal Cord. 2010;48(9):704-9.
http://www.ncbi.nlm.nih.gov/pubmed/20125107

Butler Forslund E, Roaldsen KS, Hultling C, Wahman K, Franzén E. Concerns about falling in wheelchair users with spinal cord injury-validation of the Swedish version of the spinal cord injury falls concern scale. Spinal Cord. 2016;54(2):115-9.
http://www.ncbi.nlm.nih.gov/pubmed/26261075

Galante-Maia GA, Magalhaes LC, Teixeira-Salmela LF, Scianni AA. Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the spinal cord injury – Falls Concern Scale. Spinal Cord. 2022; 60(3):1993-198
https://pubmed.ncbi.nlm.nih.gov/34168266/

Marquez MA, Santis RD, AMmendola V, Antonacci M, Santilli V, Berardi A, Valente D, Galeoto G. Cross-cultural adaptation and validation of the “spinal cord injury-falls concern scale” in the Italian population. Spinal Cord. 2018;56(7): 712-718.
https://pubmed.ncbi.nlm.nih.gov/29449685/

Pramodhyakul N, Pramodhyakul W. Thai translation and cross-cultural adaptation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS). Spinal Cord. 2020; 58(5):581-586
https://pubmed.ncbi.nlm.nih.gov/31862985/

Roaldsen KS, Måøy ÅB, Jørgensen V, Stanghelle JK. Test-retest reliability at the item level and total score level of the Norwegian version of the Spinal Cord Injury Falls Concern Scale (SCI-FCS). J Spinal Cord Med. 2016;39(3):317-26.
http://www.ncbi.nlm.nih.gov/pubmed/26829977