Validation of the Reintegration to Normal Living Index for Community-Dwelling Persons With Chronic Spinal Cord Injury

Hitzig SL, Romero Escobar EM, Noreau L, Craven BC. Validation of the Reintegration to Normal Living Index for community-dwelling persons with chronic spinal cord injury. Arch Phys Med Rehabil 2012:93:108-14. Objective: To determine the validity (construct, concurrent) of the Reintegration to Normal Living (RNL) Index for measurement of community participation in adults with chronic spinal cord injury (SCI). Design: Cross-sectional telephone survey. Setting: Rehabilitation institute. Participants: Community-dwelling adult men and women (N=617) with SCI who were at least I year postinjury. Interventions: Not applicable. Main Outcome Measures: RNL Index and Satisfaction With Life Scale (SWLS). Results: Reliability of the RNL Index was determined by using Cronbach alpha, and construct validity was established through confirmatory factor analysis (CFA). In addition, general linear models to predict RNL Index scores were conducted to establish concurrent validity. The RNL Index is a reliable measure of community participation (alpha=.87). CFA analyses suggested that the RNL Index loads onto a 2-factor solution and is distinct from the SWLS. Significant predictors of RNL Index score included years post-injury, impairment, ambulatory status, employment, and poor health, which yielded R-2=.26 (P <.001). Conclusions: The RNL Index is a valid and reliable measure of community participation for persons with chronic SCI of traumatic cause.