Center for Outcomes & Measurement

Spinal Cord Independence Measure, Version III Administration & Scoring Guidelines

The Spinal Cord Independence Measure Version III (SCIM-III) is designed for individuals with spinal cord injury (SCI) and assesses performance in activities of daily living and mobility. It is frequently used in both clinical practice and clinical trial settings.

Because the SCIM-III form is not accompanied by a manual that provides guidelines for standardization in administration and scoring, there is a risk that variation in procedures for administration and scoring across trials may limit the opportunity for comparison of outcomes or harmonization of data. To improve standardization and scoring of the SCIM-III, the Center for Outcomes and Measurements at Thomas Jefferson University used a Modified Delphi Survey and engaged experts in SCI to develop clear procedural guidelines for the administration and scoring of the SCIM-III. The iterative Modified Delphi Survey methodology did not alter any SCIM-III item or scoring criteria. Rather it focused entirely on providing clarity and standardized instructions for administering and scoring SCIM-III items, with the goal to provide the field with a resource for when the SCIM-III is used in an observation by performance or in interview format to assess endpoints of clinical trials.  

Guidelines were created for two subscales: self-care (six items) and mobility (nine items). A total score of 60 can be obtained, with self-care scores ranging from 0-20 and mobility scores from 0-40. As a performance measure, participants should perform SCIM-III self-care and mobility items using their best/maximal performance as long as the participant is deemed safe.

Utilization of these guidelines is encouraged, but they may not be altered.