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Catz A, Itzkovich M, Elkayam K, Michaeli D, Gelernter I, Benjamini Y, Chhabra HS, Tesio L, Engel-Haber E, Bizzarini E, Pilati C, Popolo GD, Baroncini I, Liu N, Margalho P, Soeira TP, Chandy B, Joshi M, Lemay JF, Curran D, Leiulfsrud AS, Sørensen L, Biering-Sorensen F, Kesiktas N, Osman A, Bluvshtein V. Reliability validity and responsiveness of the spinal cord independence measure 4 th version in a multicultural setup. Arch Phys Med Rehabil 2021; 103:430-440.e1. [PMID: 34687675 DOI: 10.1016/j.apmr.2021.07.811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE To examine the fourth version of the Spinal Cord Independence Measure for reliability and validity. DESIGN Partly blinded comparison with the criterion standard Spinal Cord Independence Measure III, and between examiners and examinations. SETTING A multicultural cohort from 19 spinal cord injury units in 11 countries. PARTICIPANTS Six hundred and forty-eight patients with spinal cord injury. INTERVENTION Assessment with Spinal Cord Independence Measure (SCIM IV) and Spinal Cord Independence Measure (SCIM III) on admission to inpatient rehabilitation and before discharge. MAIN OUTCOME MEASURES SCIM IV interrater reliability, internal consistency, correlation with and difference from SCIM III, and responsiveness. RESULTS Total agreement between examiners was above 80% on most SCIM IV tasks. All Kappa coefficients were above 0.70 and statistically significant (p<0.001). Pearson's coefficients of the correlation between the examiners were above 0.90, and intraclass correlation coefficients were above 0.90. Cronbach's alpha was above 0.96 for the entire SCIM IV, above 0.66 for the subscales, and usually decreased when an item was eliminated. Reliability values were lower for the subscale of respiration and sphincter management, and on admission than at discharge. SCIM IV and SCIM III mean values were very close, and the coefficients of Pearson correlation between them were 0.91-0.96 (p<0.001). The responsiveness of SCIM IV was not significantly different from that of SCIM III in most of the comparisons. CONCLUSIONS The validity, reliability, and responsiveness of SCIM IV, which was adjusted to assess specific patient conditions or situations that SCIM III does not address, and which includes more accurate definitions of certain scoring criteria, are very good and quite similar to those of SCIM III. SCIM IV can be used for clinical and research trials, including international multi-center studies, and its group scores can be compared with those of SCIM III.
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Affiliation(s)
- Amiram Catz
- Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Malka Itzkovich
- Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Keren Elkayam
- Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel
| | - Dianne Michaeli
- Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel
| | - Ilana Gelernter
- School of Mathematical Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Benjamini
- School of Mathematical Sciences, Tel Aviv University, Tel Aviv, Israel
| | | | - Luigi Tesio
- Istituto Auxologico Italiano, IRCCS, and Università degli Studi, Milan, Italy
| | - Einat Engel-Haber
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Neurological Rehabilitation, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | | | | | | | | | - Nan Liu
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | | | | | - Bobeena Chandy
- Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, Tamil Nadu, India
| | - Mrinal Joshi
- Department of Physical Medicine and Rehabilitation, Rehabilitation Research Center, SMS Medical College & Associated Hospitals, Jaipur, India
| | | | | | - Annelie Schedin Leiulfsrud
- St Olav University Hospital, Clinic of Physical Medicine and Rehabilitation, Department of Spinal Cord Injuries, Trondheim, Norway
| | - Linda Sørensen
- Department of Innovation, Technology and E-Health, Sunnaas Rehabilitation Hospital HF, Nesoddtangen, Norway
| | - Fin Biering-Sorensen
- Department of Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Denmark
| | - Nur Kesiktas
- Istanbul Physical Medicine and Rehabilitation University of Health Sciences, Turkey
| | - Aheed Osman
- Robert Jones & Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Vadim Bluvshtein
- Department of Spinal Rehabilitation, Loewenstein Rehabilitation Medical Center, Raanana, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Emamhadi M, Haghani Dogahe M, Gohritz A. Nerve transfers in tetraplegia: a review and practical guide. J Neurosurg Sci 2021; 65:431-441. [PMID: 33870671 DOI: 10.23736/s0390-5616.21.05312-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Spinal cord injury (SCI) may lead to tetraplegia. Several nerve transfers have been successfully used for the restoration of the upper limb in tetraplegia. Reconstruction of an upper limb is individualized based on the functional level. In this study, the authors reviewed nerve transfers based on the injury level for the restoration of upper limb function in tetraplegia. EVIDENCE ACQUISITION We performed this study to review nerve transfers in tetraplegia by searching MEDLINE and EMBASE databases to identify relevant articles published through December 2020. We selected studies that reported cases in tetraplegia and extracted information on demographic data, clinical characteristics, operative details, and strength outcomes based on each injury level after surgery. EVIDENCE SYNTHESIS Total of 29 journal articles reporting on 275 nerve transfers in 172 upper limbs of 121 patients were included in the review. The mean time between SCI and nerve transfer surgery was 21.37 months (range: 4-156 months), and the follow-up time was 21.34 months (range: 3-38 months). The best outcomes were achieved for the restoration of wrist/finger extension and elbow extension. CONCLUSIONS Nerve transfer can provide a new function in tetraplegic patients' upper limbs to improve daily living activities. The type of surgical procedure should be performed based on the functional level of SCI and the individual's needs. Functional recovery occurs more in extensor muscles than flexors. Nerve transfer is a promising option in the reconstruction of upper limb function in tetraplegia.
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Affiliation(s)
- Mohammadreza Emamhadi
- Brachial Plexus and Peripheral Nerve Injury Center, Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran -
| | - Mohammad Haghani Dogahe
- Brachial Plexus and Peripheral Nerve Injury Center, Department of Neurosurgery, Guilan University of Medical Sciences, Rasht, Iran
| | - Andreas Gohritz
- Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital Basel, Basel, Switzerland
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