• Assesses the impact of spasticity on daily life in people with SCI.
  • Requires participants to recall their past 7 days when rating spasticity on a scale ranging from -3 (extremely problematic) to +3 (extremely helpful)
  • The Modified SCI-SET was proposed by Sweatman et al. (2020).

Clinical Considerations

  • The SCI-SET can be used as a tool for medical management decisions as well as a measurement of current treatment effects.
  • Spasticity is known to be highly variable, fluctuating on a daily and even hourly basis. A seven day recall of the impact of spasticity may be overshadowed by current levels of spasticity. Repeated administration may therefore be necessary to provide a more accurate picture of the impacts spasticity has on daily life.
  • The SCI-SET was developed specifically for the SCI population.
  • The scale is easy to administer and score. Definitions of ‘spasm’ and the scale responses are clearly outlined in the instructions.

ICF Domain

Body Function ▶ Neuromusculoskeletal & Movement-related Functions and Structures

Administration

  • Self-report questionnaire.
  • Can be administered in person or over the phone.

Number of Items

  • 35 (SCI-SET)
  • 33 (Modified SCI-SET)

Equipment

None

Scoring

  • SCI-SET: Total score (-3 to +3) is generated by summing all the responses from the applicable items then dividing the sum by the number of applicable items.
  • Modified SCI-SET: Same score, but you are summing item scores ranging from -2 to +1.

Languages

English, Turkish, and Persian

Training Required

No advanced training required.

Availability

# of studies reporting psychometric properties: 5

Interpretability

  • No meaningful cut points or norms have been established for the SCI population
  • Published data is available for comparison (see Interpretability section of the Research Summary sheet).

MCID: not established in SCI.
SEM: 0.17-0.30
MDC: 0.47-0.82

(Adams et al. 2007; Ansari et al. 2017)

Reliability – Moderate to High

  • The SCI-SET was administered 3 times, 3 weeks in a row, on the same day of the week.
  • Internal consistency of the SCI-SET is high (Cronbach’s a = 0.862-0.95), as is the test-retest reliability (ICC = 0.80-0.91).
  • There is moderate to high test-retest reliability for transfer-related variables (rho = 0.656-0.846).

(Adams et al. 2007; Akpinar et al. 2017; Ansari et al. 2017; Tibbett et al. 2019)

  • Internal consistency of the Modified SCI-SET is high (Cronbach’s a = 0.96)

(Sweatman et al. 2020)

Validity – Moderate to High

  • The SCI-SET score has high positive and negative correlations between SCI-SET scores and Self-assessment of Spasticity Impact (r = -0.61), Quality of Life Index health and functioning subscale (r = 0.68), and the Penn Spasm Frequency Scale (r = -0.66).
  • The SCI-SET score has moderate positive and negative correlations between SCI-SET scores and Self-assessment of spasticity severity (r = -0.41), self-assessment of spasticity impact (r = -0.47), Self-assessment of Spasticity Severity (r = -0.48).
  • The SCI-SET score has moderate to high correlation with the Modified PRISM (physical = -0.492; psychological = -0.640; social = -0.561).
  • The SCI-SET has high correlation with the Modified SCI-SET (r = 0.975)

(Adams et al. 2007; Akpinar et al. 2017; Ansari et al. 2017; Sweatman et al. 2020)

Responsiveness

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

Floor/Ceiling Effect

Original SCI-SET

  • At ceiling (%) = 0.0
  • At floor (%) = 0.4

Modified SCI-SET

  • At ceiling (%) = 0.4
  • At floor (%) = 0.4

(Sweatman et al. 2020)

Reviewers

Jane Hsieh, Dr. Carlos L. Cano-Herrera, Elsa Sun, Tyra Chu

Date Last Updated

31 December 2024

Adams M, Martin Ginis K, Hicks A. The Spinal Cord Injury Spasticity Evaluation Tool: Development and Evaluation. Arch Phys Med Rehabil. 2007;88:1185-1192.
http://www.ncbi.nlm.nih.gov/pubmed/17826466

Akpinar P, Atici A, Kurt KN, Ozkan FU, Aktas I, Kulcu DG. Reliability and cross-cultural adaptation of the Turkish version of the Spinal Cord Injury Spasticity Evaluation Tool. International Journal of Rehabilitation Research 2017, 40:152–157
https://pubmed.ncbi.nlm.nih.gov/28225536/

Ansari, NN, Kashi M, Naghdi S. The Spinal Cord Injury Spasticity Evaluation Tool: A Persian adaptation and validation study. The Journal of Spinal Cord Medicine 2017, 40 (4).
https://pubmed.ncbi.nlm.nih.gov/27579622/

Tibbet J, Widerström-Noga EG, Thomas CK, Field-Fote EC. Impact of spasticity on transfers and activities of daily living in individuals with spinal cord injury. The Journal of Spinal Cord Medicine. 2019 42:3, 318-327
https://pubmed.ncbi.nlm.nih.gov/29334339/

Sweatman WM, Heinemann AW, Furbish CL, Field-Fote EC. Modified PRISM and SCI-SET Spasticity Measures for Persons With Traumatic Spinal Cord Injury: Results of a Rasch Analyses. 2020;101(9):1570-1579. https://pubmed.ncbi.nlm.nih.gov/32497601/

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