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Walking Index for Spinal Cord Injury (WISCI II)
Availability
Available at the Spinal Cord Injury Center website: Walking Index for Spinal Cord Injury
Classification
Supplemental: Spinal Cord Injury (SCI) and SCI-Pediatric (age 3 and over)
Short Description of Instrument
Construct measured: Ambulatory ability and independence
Generic vs. disease specific: Disease Specific
Comments/Special Instructions
Scoring: Scoring is as follows:
 
    0 Client is unable to stand and/or participate in assisted walking.
    1 Ambulates in parallel bars, with braces and physical assistance of two persons, less than 10 meters.
    2 Ambulates in parallel bars, with braces and physical assistance of two persons, 10 meters.
    3 Ambulates in parallel bars, with braces and physical assistance of one person, 10 meters.
    4 Ambulates in parallel bars, no braces and physical assistance of one person, 10 meters.
    5 Ambulates in parallel bars, with braces and no physical assistance, 10 meters.
    6 Ambulates with walker, with braces and physical assistance of one person, 10 meters.
    7 Ambulates with two crutches, with braces and physical assistance of one person, 10 meters.
    8 Ambulates with walker, no braces and physical assistance of one person, 10 meters.
    9 Ambulates with walker, with braces and no physical assistance, 10 meters.
    10 Ambulates with one cane/crutch, with braces and physical assistance of one person, 10 meters.
    11 Ambulates with two crutches, no braces and physical assistance of one person, 10 meters.
    12 Ambulates with two crutches, with braces and no physical assistance, 10 meters.
    13 Ambulates with walker, no braces and no physical assistance, 10 meters.
    14 Ambulates with one cane/crutch, no braces and physical assistance of one person, 10 meters.
    15 Ambulates with one cane/crutch, with braces and no physical assistance, 10 meters.
    16 Ambulates with two crutches, no braces and no physical assistance, 10 meters.
    17 Ambulates with no devices, no braces and physical assistance of one person, 10 meters.
    18 Ambulates with no devices, with braces and no physical assistance, 10 meters.
    19 Ambulates with one cane/crutch, no braces and no physical assistance, 10 meters.
    20 Ambulates with no devices, no braces and no physical assistance, 10 meters.
 
Background: The WISCI-II was developed to assess the amount of assistance needed and whether devices are needed following paralysis in individuals with SCI.
Rationale/Justification
Strengths/Weaknesses: While this measure is widely used, scoring criteria are based on the assistive device used, distance walked, bracing used, and physical assist required. Since assistive device selection is largely based on therapist preference (a study by Saensook and colleagues (2014) showed functional tests do not discriminate between those who walk with a walker vs. crutches). Speed and distance walked are more standardized measures and are covered in 10 Meter Walk Test and the timed walk test.
 
SCI-Pediatric-specific: One pilot study (Calhoun et al., 2012) to date examines the use of the WISCI in children. This pilot study recruited children as young as 5 but younger children may be able to participate if they can walk and understand directions. Based on discussion with clinicians, it is possible to use the measure with children as young as 3 years of age.
References
Dittuno PL, Ditunno JF Jr. Walking index for spinal cord injury (WISCI II): scale revision. Spinal Cord. 2001;39(12):654–656. Erratum in: Spinal Cord. 2009;47(4):349.
 
Ditunno JF Jr, Ditunno PL, Scivoletto G, Patrick M, Dijkers M, Barbeau H, Burns AS, Marino RJ, Schmidt-Read M. The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse. Spinal Cord. 2013;51(5):346–355.
 
Saensook W, Poncumhak P, Saengsuwan J, Mato L, Kamruecha W, Amatachaya S. Discriminative ability of the three functional tests in independent ambulatory patients with spinal cord injury who walked with and without ambulatory assistive devices. J Spinal Cord Med. 2014;37(2):212–217.
 
SCI-Pediatric References:
 
Calhoun CL, Mulcahey MJ. Pilot study of reliability and validity of the Walking Index for Spinal Cord Injury II (WISCI-II) in children and adolescents with spinal cord injury. J Pediatr Rehabil Med. 2012;5(4):275–279.
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