• Specifically measures the frequency that people with SCI get associate secondary conditions that directly and indirectly impact health and physical functioning.
  • Items were selected based on 3 criteria:
    1. That they represent conditions that are physiologic in nature (vs psychological or environmental).
    2. That they are measurable by patient history and physical examination, reported episodes, validated scales, or medical tests or interventions.
    3. Those that can be either prevented or managed with medical intervention and/or health behaviors.
  • Items represent problems in the areas of skin, musculoskeletal, pain, bowel/bladder, and cardiovascular.

ICF Domain

Body Function ▶ General Functions


  • Self-report questionnaire
  • The rating scale uses a 4-point ordinal scale ranging from 0 (not experienced/insignificant problem never limiting activity) to 3 (significant/chronic problem).

Number of Items





Total score (0 – 48) is derived from the sum of the problem ratings.



Training Required

No advanced training required.


Can be found here.

# of studies reporting psychometric properties: 1


  • Total scores range from 0 to 48
  • Higher scores indicate greater overall problems with secondary conditions.
  • No meaningful cut points, normative data or responsiveness data have been established at this time for the SCI population.
  • Published data for the SCI population is available for comparison (see Interpretability section of the Research Summary).

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


  • The SCI-SCS was administered across 5 time-points, spanning 2 years post-intervention.
  • The internal consistency across each of the time points was Moderate to High (Cronbach’s a=0.73 – 0.869).
  • The test-retest reliability values across the time points ranged from Moderate to High (r=0.569-0.91).

(Kalpakjian et al. 2007; Conti et al. 2019; Arora et al. 2015)


The SCI-SCS total score has Moderate to High correlations with the 6 items of the SF-12 (r=0.317 to 0.644); Moderate correlations with the SF-8 Physical Component (PCS) and Patient Health Questionnaire (r=0.36 and 0.43) (PHQ-9), and Low correlations with the Modified Barthel Index (MBI), SF-8 Mental Component summary (PCS), Generalized Anxiety Disorder-7 (GAD-7), and Tetraplegia (r=0.20-0.30).

(Kalpakjian et al. 2007; Conti et al. 2019)


No values were reported for the responsiveness of the SCI-SCS for the SCI population.

Floor/Ceiling Effect

  • There are ceiling effects on 3 categories of secondary conditions (>20% scored in the highest category):
    • Sexual dysfunction (26.2%)
    • Chronic pain (32.3%)
    • Joint and muscle pain (29.2%)
  • There are floor effects on all 16 categories of secondary conditions (>20% scored in the lowest category):
    • Injury caused by loss of sensation (76.9%)
    • Muscle spasms (41.5%)
    • Contractures (67.7%)
    • Heterotopic bone ossification (89.2%)
    • Diabetes mellitus (87.7%)
    • Bladder dysfunction (36.9%)
    • Bowel dysfunction (40.0%)
    • Urinary tract infections (61.5%)
    • Sexual dysfunction (43.1%)
    • Autonomic dysreflexia (70.8%)
    • Postural hypotension (80.0%)
    • Circulatory problems (50.8%)
    • Respiratory problems (80.0%)
    • Chronic pain (33.8%)
    • Joint and muscle pain (29.2%)

(Kalpakjian et al. 2007; Conti et al. 2019)


Dr. Vanessa Noonan, John Zhu, Jeremy Mak, Matthew Querée, Risa Fox

Date Last Updated

3 August 2020

Arora M, Harvey LA, Lavrencic L, Bowden JL, Nier L, Glinsky JV, Hayes AJ, Cameron ID. A telephone-based version of the spinal cord injury-secondary conditions scale: a reliability and validity study. Spinal Cord. 2016;54(5):402-5.

Conti A, Clari M, Arese S, Bandini B, Cavallaro L, Mozzone S, Vellone F, Frigero S, Campagna S. Validation and psychometric evaluation of the Italian version of the Spinal Cord Injury Secondary Conditions Scale. Spinal Cord. 2020;58(4):496-503.

Kalpakjian CZ, Scelza WM, Forchheimer MB, Toussaint LL. Preliminary Reliability and Validity of a Spinal Cord Injury Secondary Conditions Scale. The Journal of Spinal Cord Medicine 2007; 30: 131-39.