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Correspondence to “Development and validation of the sitting balance assessment for spinal cord injury (SitBASCI)”

Spinal Cord volume 61, pages 288–289 (2023)Cite this article

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We read with interest the paper by Guizzardi et al. published in Spinal Cord on the development and validation of the sitting balance assessment for spinal cord injury (SitBASCI) [1]. Functional sitting balance and trunk stability are high priority constructs related to quality of life in individuals with spinal cord injury (SCI) [2]. Valid and reliable assessments of seated balance are required to aid clinicians in selecting appropriate interventions and monitoring progress over the lifespan of individuals with SCI. The development of the SitBASCI may be important to the advancement of the field and help clinicians working with individuals with SCI to provide targeted care. However, we believe that concerns exist regarding the validity of the SitBASCI that needs to be further clarified to avoid any misunderstanding among researchers and clinicians working in the field.

In the recent manuscript, Guizzardi et al. touch on some advancements in the field stating in their introduction: “… the Scale Community Balance & Mobility Scale (CB&M), the Activities-specific Balance Confidence (ACB) Scale, the Function in Sitting Test (FIST) and the Sitting Balance Score (SBS), adapted and validated for SCI populations, were tested only for limited types of injury (iSCI) or chronic SCI and needed major revisions.”[1] While sitting balance assessments in SCI used to be an important limitation due to the lack of valid and reliable outcome measures specific for this population, several recent studies have covered this topic and a range of clinically and ecologically valid outcome measures have been validated for this population [3]. However, Guizzardi et al. fail to refer to these important updates in their study. The authors fail to mention that the Function in Sitting Test (FIST) for example, initially investigated in the SCI population [4], has undergone modification and adaptation for individuals with SCI (FIST-SCI) and is reliable and valid in the chronic SCI population [5]. Further, both the Trunk Control Test (TCT) [6] and FIST-SCI [5] were identified as appropriate assessments for the non-chronic and chronic SCI populations in a recent review by Ciardi and Nicolini [3]. These authors view the lack of comparison of the SitBASCI with a functional sitting balance assessment (i.e., the TCT or FIST-SCI) or with a biomechanics gold standard assessment (i.e., force plate assessment) as a crucial limitation of the work completed by Guizzardi et al. [1]. Therefore, validity of the SitBASCI cannot be ‘yet’ claimed and consequently, recommending its use in clinical setting and in future research is questionable.

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References

  1. Guizzardi A, Artuso P, Bianconi T, Bandini B, Grotto E, Guazzini A, et al. Development and validation of the sitting balance assessment for spinal cord injury (SitBASCI). Spinal Cord. 2022;60:826–30.

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Authors and Affiliations

  1. Neuroscience Research Australia, Sydney, NSW, Australia

    Anne E. Palermo

  2. University of New South Wales School of Medicine and Health, Sydney, NSW, Australia

    Anne E. Palermo

  3. Department of Physical Medicine & Rehabilitation Michigan Medicine, University of Michigan, Ann Arbor, MI, USA

    Libak Abou

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  1. Anne E. Palermo
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  2. Libak Abou
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AEP and LA jointly discussed, drafted, and edited this correspondence.

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Correspondence to Anne E. Palermo.

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Palermo, A.E., Abou, L. Correspondence to “Development and validation of the sitting balance assessment for spinal cord injury (SitBASCI)”. Spinal Cord 61, 288–289 (2023). https://doi.org/10.1038/s41393-023-00878-2

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