Table 1.

Assessment of lower extremities function in SCI: global strengths and limitations of outcome measures

Scale		Strengths	Limitations
Continuous	Advanced clinical diagnostic measures (e-phys)	◦ Detailed analysis ◦ Discrimination of extent and injury subtypes (e.g., cyst, central cord syndrome,…) ◦ Can identify mechanisms underlying gait dysfunction ◦ Can produce linear measures	◦ requires expensive equipment and skilled examiner ◦ Do not assess walking function directly ◦ Complex post-processing
	Timed measures (10MWT, 6mWT, TUG)	◦ Simple and unidimensional ◦ Readily quantified ◦ Requires limited training ◦ Published norms available ◦ Often used in clinical trials	◦ Do not identify mechanisms underlying gait dysfunction ◦ Cannot discriminate compensatory strategies
	Spatiotemporal gait analysis and posturography	◦ Identify mechanisms underlying gait dysfunction ◦ Provide precise electrophysiological, kinematic, kinetic, and spatiotemporal data	◦ Requires mostly expensive equipment and skilled examiner ◦ Complex post-processing ◦ Limited to a few specialized laboratories ◦ Limited clinical impact
Ordinal	Standard clinical measure (ISNCSCI)	◦ Gold standard in clinical trials ◦ Minimal equipment (g-Tip, safety pin) required	◦ Requires a skilled examiner ◦ limited information about mechanisms underlying gait dysfunction ◦ Limited accuracy and sensitivity ◦ non-linear ordinal measures
	Gait quality measures (NRS, SCI-FAI, SCI-FAP)	Can identify mechanisms underlying gait dysfunction require limited equipment	◦ Limited precision ◦ Require skilled examiners ◦ Can be affected from floor/ ceiling effects
	Clinical LE outcome measures (WISCI II, SCIM III, FIM, BBS, Mini-BESTest)	◦ Can document the use of assistive devices ◦ Require limited time to administer ◦ Can be assessed in clinic and in community	◦ Require assessment training ◦ No or limited information about mechanisms underlying gait dysfunction ◦ Can be affected from floor/ ceiling effects

Modified after Cameron et al. [47]

ISNCSCI International standards for neurological classification of spinal cord injury, 10MWT ten meter walk test, 6mWT six minute walk test, TUG timed up and go test, SCAR spinal cord ability ruler, WISCI II walking index for spinal cord injury II, SCIM III spinal cord independence measure III, FIM functional Independence Measure, SCI-FAI spinal cord injury functional ambulation inventory, SCI-FAP Spinal cord injury functional ambulation profile, BBS Berg Balance Scale, NRS neuromuscular recovery score