Development of the SCI-BodyMap: Measuring Mental Body Representations in Adults with Spinal Cord Injury

Abstract There is evidence that adults with spinal cord injury (SCI) have deficits in mental body representations (e.g., altered visuospatial body maps and reduced body awareness), due to the diminished or lack of sensory information reaching the brain. These mental body representation deficits are important and need to be quantified, because they can impact daily functioning and they are associated with neuropathic pain. The currently available evaluation scales measure certain aspects of mental body representations with few having been assessed in adults with spinal cord injury. Furthermore, to our knowledge, no scales have been developed specifically for adults with spinal cord injury. Therefore, to address this gap, we completed two aims. First, we developed a novel evaluation scale (the SCI-BodyMap) to measure SCI-specific deficits in mental body representations. Second, we assessed the psychometric properties of inter-rater reliability, test-retest reliability, concurrent validity, with the Revised Body Awareness Rating Questionnaire, the Multidimensional Assessment of Interoceptive Awareness-2, and the Numeric pain rating scale. We also assessed feasibility, utility, and face validity with the QQ-10. We found good to excellent inter-rater and test-retest reliability, with the exception of two items showing moderate test-retest reliability. We did not find any correlations between the SCI-BodyMap with the Revised Body Awareness Rating Questionnaire or the Multidimensional Assessment of Interoceptive Awareness-2 and found fair correlations between high levels of neuropathic pain on the Numeric pain rating scale with highest level of neuropathic pain on the SCI-BodyMap. The scale proved to have high feasibility, utility, and face validity. Once more psychometric analyses are performed in a bigger sample, the SCI-BodyMap could be recommended for use in research and in the clinic.