1
|
Pfender N, Jutzeler CR, Hubli M, Scheuren PS, Pfyffer D, Zipser CM, Rosner J, Friedl S, Sutter R, Spirig JM, Betz M, Schubert M, Seif M, Freund P, Farshad M, Curt A, Hupp M. Potential thresholds of critically increased cardiac-related spinal cord motion in degenerative cervical myelopathy. Front Neurol 2024; 15:1411182. [PMID: 38978814 PMCID: PMC11228334 DOI: 10.3389/fneur.2024.1411182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 06/11/2024] [Indexed: 07/10/2024] Open
Abstract
Introduction New diagnostic techniques are a substantial research focus in degenerative cervical myelopathy (DCM). This cross-sectional study determined the significance of cardiac-related spinal cord motion and the extent of spinal stenosis as indicators of mechanical strain on the cord. Methods Eighty-four DCM patients underwent MRI/clinical assessments and were classified as MRI+ [T2-weighted (T2w) hyperintense lesion in MRI] or MRI- (no T2w-hyperintense lesion). Cord motion (displacement assessed by phase-contrast MRI) and spinal stenosis [adapted spinal canal occupation ratio (aSCOR)] were related to neurological (sensory/motor) and neurophysiological readouts [contact heat evoked potentials (CHEPs)] by receiver operating characteristic (ROC) analysis. Results MRI+ patients (N = 31; 36.9%) were more impaired compared to MRI- patients (N = 53; 63.1%) based on the modified Japanese Orthopedic Association (mJOA) subscores for upper {MRI+ [median (Interquartile range)]: 4 (4-5); MRI-: 5 (5-5); p < 0.01} and lower extremity [MRI+: 6 (6-7); MRI-: 7 (6-7); p = 0.03] motor dysfunction and the monofilament score [MRI+: 21 (18-23); MRI-: 24 (22-24); p < 0.01]. Both patient groups showed similar extent of cord motion and stenosis. Only in the MRI- group displacement identified patients with pathologic assessments [trunk/lower extremity pin prick score (T/LEPP): AUC = 0.67, p = 0.03; CHEPs: AUC = 0.73, p = 0.01]. Cord motion thresholds: T/LEPP: 1.67 mm (sensitivity 84.6%, specificity 52.5%); CHEPs: 1.96 mm (sensitivity 83.3%, specificity 65.6%). The aSCOR failed to show any relation to the clinical assessments. Discussion These findings affirm cord motion measurements as a promising additional biomarker to improve the clinical workup and to enable timely surgical treatment particularly in MRI- DCM patients. Clinical trial registration www.clinicaltrials.gov, NCT02170155.
Collapse
Affiliation(s)
- Nikolai Pfender
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | | | - Michèle Hubli
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Paulina S Scheuren
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Dario Pfyffer
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- School of Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, United States
| | - Carl M Zipser
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Jan Rosner
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Neurology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
| | - Susanne Friedl
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Reto Sutter
- Department of Radiology, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - José M Spirig
- University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Michael Betz
- University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Martin Schubert
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Maryam Seif
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Patrick Freund
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- Department of Neurophysics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Mazda Farshad
- University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Armin Curt
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
- University Spine Center Zurich, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| | - Markus Hupp
- Spinal Cord Injury Center, Balgrist University Hospital, University of Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Poutanen J, Savolainen S, Shulga A, Arokoski J, Hiekkala S. ICF-linking and psychometric properties of upper extremity mobility outcome measures in spinal cord injury - a scoping review. J Spinal Cord Med 2024; 47:201-213. [PMID: 36622355 PMCID: PMC10885769 DOI: 10.1080/10790268.2022.2161867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE The purpose of this study was to explore the outcome measures used in upper extremity rehabilitation and research in spinal cord injury and to investigate their psychometry. DESIGN Scoping review. DATA SOURCES PubMed, the Cochrane library, PEDro, Medline (Ovid). ELIGIBILITY CRITERIA FOR SELECTING STUDIES The search process and study selection was carried out as follows: Firstly, a systematic search was carried out for articles on upper extremity rehabilitation after SCI. Performance or observational outcome measures which were designed for a clinical setting were collected from selected studies. Secondly, eligible outcome measures were linked to the ICF. The ICF-linked outcome measures were further screened for inclusion according to how comprehensively they covered ICF categories. Finally, a search of the selected outcome measures was performed to investigate their psychometry. RESULTS A total of four outcome measures and nine psychometric studies were selected for the scoping review; six studies addressed GRASSP, one addressed AuSpinal, one addressed SHFT and one addressed TRI-HFT. Of the 13 COSMIN measurement properties, studies of GRASSP covered seven, AuSpinal covered five and both SHFT and TRI-HFT covered three properties. CONCLUSIONS The psychometric properties of GRASSP were most extensively studied showing eligible reliability and validity. Although there are still some measurement properties to be explored, GRASSP can be recommended for use in the evaluation of upper extremity mobility in the SCI rehabilitation and research. More research is needed on the psychometrics of other outcome measures in people with spinal cord injuries before the outcome measures can be unconditionally recommended.
Collapse
Affiliation(s)
- Joonas Poutanen
- Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Sarianna Savolainen
- BioMag Laboratory, Helsinki University Hospital, Helsinki, Finland
- Validia Ltd., Helsinki, Finland
| | - Anastasia Shulga
- BioMag Laboratory, Helsinki University Hospital, Helsinki, Finland
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- Department of Surgery, University of Helsinki, Helsinki, Finland
| | - Jari Arokoski
- Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, Neurology, Helsinki University Hospital, Helsinki, Finland
| | - Sinikka Hiekkala
- Validia Ltd., Helsinki, Finland
- The Finnish Association of People with Physical Disabilities, Helsinki, Finland
| |
Collapse
|
3
|
Voss S, Adighibe A, Sanders E, Aaby D, Kravitt R, Clark G, Breen K, Barry A, Forrest GF, Kirshblum SC, Perez MA, Kalsi-Ryan S, Kocherginsky M, Rymer WZ, Sandhu MS. Development of a Remote Version of the Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP): Validity and Reliability. Neurorehabil Neural Repair 2023; 37:83-93. [PMID: 36987396 PMCID: PMC10939131 DOI: 10.1177/15459683231162830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023]
Abstract
BACKGROUND The Graded Redefined Assessment of Strength, Sensation, and Prehension (GRASSP V1.0) was developed in 2010 as a 3-domain assessment for upper extremity function after tetraplegia (domains: Strength, Sensibility, and Prehension). A remote version (rGRASSP) was created in response to the growing needs of the field of Telemedicine. OBJECTIVE The purpose of this study was to assess the psychometric properties of rGRASSP, establishing concurrent validity and inter-rater reliability. METHODS Individuals with tetraplegia (n = 61) completed 2 visits: 1 in-person and 1 remote. The first visit was completed in-person to administer the GRASSP, and the second visit was conducted remotely to administer the rGRASSP. The rGRASSP was scored both by the administrator of the rGRASSP (Examiner 1), and a second assessor (Examiner 2) to establish inter-rater reliability. Agreement between the in-person and remote GRASSP evaluations was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman agreement plots. RESULTS The remote GRASSP demonstrated excellent concurrent validity with the GRASSP (left hand intraclass correlation coefficient (ICC) = .96, right ICC = .96). Concurrent validity for the domains was excellent for strength (left ICC = .96, right ICC = .95), prehension ability (left ICC = .94, right ICC = .95), and prehension performance (left ICC = .92, right ICC = .93), and moderate for sensibility (left ICC = .59, right ICC = .68). Inter-rater reliability for rGRASSP total score was high (ICC = .99), and remained high for all 4 domains. Bland-Altman plots and limits of agreements support these findings. CONCLUSIONS The rGRASSP shows strong concurrent validity and inter-rater reliability, providing a psychometrically sound remote assessment for the upper extremity in individuals with tetraplegia.
Collapse
Affiliation(s)
| | | | | | - David Aaby
- Department of Preventative Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Gina Clark
- Shirley Ryan Ability Lab, Chicago, IL, USA
| | | | | | - Gail F. Forrest
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Steve C. Kirshblum
- Kessler Foundation, West Orange, NJ, USA
- Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Monica A. Perez
- Shirley Ryan Ability Lab, Chicago, IL, USA
- Edward Hines Jr. VA Hospital, Hines, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Masha Kocherginsky
- Department of Preventative Medicine, Division of Biostatistics, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - William Zev Rymer
- Shirley Ryan Ability Lab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Milap S. Sandhu
- Shirley Ryan Ability Lab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| |
Collapse
|
4
|
Kalsi-Ryan S, Balbinot G, Wang JZ, Abel R, Bolliger M, Curt A, Fehlings MG, Jin D, Verrier M, Velstra IM. Minimal Clinically Important Difference of Graded Redefined Assessment of Strength, Sensibility, and Prehension Version 1 in Acute Cervical Traumatic Spinal Cord Injury. J Neurotrauma 2022; 39:1645-1653. [PMID: 35652348 DOI: 10.1089/neu.2021.0500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
The Graded Redefined Assessment of Strength, Sensibility, and Prehension Version 1 (GRASSP v1) is a validated measure of upper extremity impairment shown to be sensitive and responsive for traumatic cervical spinal cord injury (SCI) in both North American (NA) and European (EU) cohorts. The minimal clinically important difference (MCID) is the quantitative change in an assessment scale that patients perceive as being beneficial. Our aim was to establish the MCID of all subtests of the GRASSP v1 for cervical SCI. We prospectively analyzed 127 patients from NA and EU for up to six months after motor complete and incomplete cervical SCI using the GRASSP v1, Spinal Cord Independence Measure, and International Standards of Neurological Classification of Spinal Cord Injury. We used a patient global rating of change and the anchor-based method to calculate MCID of GRASSP v1 at six months post-injury. The MCID was established for the whole group, dividing the sample by "better" and "much better." Improvement in GRASSP v1 Strength and Prehension Performance scores of 13 and 3 are the MCID for the better category, and 19 and 7 are the MCID for the much better category, respectively. The MCID was also established for the motor complete and incomplete groups. Improvement in GRASSP v1 Strength and Prehension Performance scores of 12 and 6 are the MCID for the motor complete group, and 17 and 12 are the MCID for the motor incomplete group, respectively. The GRASSP v1 Strength subscore is the most sensitive for detecting meaningful clinical change in patients and is most closely related to measures of independence. Thus, use of GRASSP v1 Strength and Prehension Performance as measures of change is substantiated by this study.
Collapse
Affiliation(s)
- Sukhvinder Kalsi-Ryan
- Toronto Rehabilitation Institute-UHN, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, Toronto, Ontario, Canada
| | | | - Justin Zhang Wang
- University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, Toronto, Ontario, Canada
| | - Rainer Abel
- Spinal Cord Injury Centre, Hohe Warte, Bayreuth, Germany.,European Multicenter Study about Human Spinal Cord Injury, Zurich, Switzerland
| | - Marc Bolliger
- Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland
| | - Armin Curt
- Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland
| | - Michael G Fehlings
- University of Toronto, Toronto, Ontario, Canada.,Department of Surgery, Toronto, Ontario, Canada.,Krembil Neuroscience Centre, Toronto, Ontario, Canada
| | - Daniel Jin
- Toronto Rehabilitation Institute-UHN, Toronto, Ontario, Canada.,University of Waterloo, Waterloo, Ontario, Canada
| | - Mary Verrier
- Toronto Rehabilitation Institute-UHN, Toronto, Ontario, Canada.,University of Toronto, Toronto, Ontario, Canada.,Department of Physical Therapy, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, Toronto, Ontario, Canada
| | - Inge-Marie Velstra
- European Multicenter Study about Human Spinal Cord Injury, Zurich, Switzerland.,Swiss Paraplegic Centre, Knotwil, Switzerland
| |
Collapse
|
5
|
Differences in sensorimotor and functional recovery between the dominant and non-dominant upper extremity following cervical spinal cord injury. Spinal Cord 2022; 60:422-427. [PMID: 35273373 DOI: 10.1038/s41393-022-00782-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 02/18/2022] [Accepted: 02/20/2022] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Post hoc analysis of prospective multi-national, multi-centre cohort study. OBJECTIVE Determine whether cerebral dominance influences upper extremity recovery following cervical spinal cord injury (SCI). SETTING A multi-national subset of the longitudinal GRASSP dataset (n = 127). METHODS Secondary analysis of prospective, longitudinal multicenter study of individuals with cervical SCI (n = 73). Study participants were followed for up to 12 months after a cervical SCI, and the following outcome measures were serially assessed - the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) and the International Standards for the Neurological Classification of SCI (ISNCSCI), including upper extremity motor and sensory scores. Observed recovery and relative (percent) recovery were then determined for both the GRASSP and ISNCSCI, based on change from initial to last available assessment. RESULTS With the exception of prehension performance (quantitative grasping) following complete cervical SCI, there were no significant differences (p < 0.05) for observed and relative (percent) recovery, between the dominant and non-dominant upper extremities, as measured using GRASSP subtests, ISNCSCI motor scores and ISNCSCI sensory scores. CONCLUSION Despite well documented differences between the cerebral hemispheres, cerebral dominance appears to play a limited role in upper extremity recovery following acute cervical SCI.
Collapse
|
6
|
Pfender N, Rosner J, Zipser CM, Friedl S, Vallotton K, Sutter R, Klarhoefer M, Schubert M, Betz M, Spirig JM, Seif M, Hubli M, Freund P, Farshad M, Curt A, Hupp M. Comparison of axial and sagittal spinal cord motion measurements in degenerative cervical myelopathy. J Neuroimaging 2022; 32:1121-1133. [PMID: 35962464 PMCID: PMC9805009 DOI: 10.1111/jon.13035] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 07/27/2022] [Accepted: 07/27/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE The timing of decision-making for a surgical intervention in patients with mild degenerative cervical myelopathy (DCM) is challenging. Spinal cord motion phase contrast MRI (PC-MRI) measurements can reveal the extent of dynamic mechanical strain on the spinal cord to potentially identify high-risk patients. This study aims to determine the comparability of axial and sagittal PC-MRI measurements of spinal cord motion with the prospect of improving the clinical workup. METHODS Sixty-four DCM patients underwent a PC-MRI scan assessing spinal cord motion. The agreement of axial and sagittal measurements was determined by means of intraclass correlation coefficients (ICCs) and Bland-Altman analyses. RESULTS The comparability of axial and sagittal PC-MRI measurements was good to excellent at all cervical levels (ICCs motion amplitude: .810-.940; p < .001). Significant differences between axial and sagittal amplitude values could be found at segments C3 and C4, while its magnitude was low (C3: 0.07 ± 0.19 cm/second; C4: -0.12 ± 0.30 cm/second). Bland-Altman analysis showed a good agreement between axial and sagittal PC-MRI scans (coefficients of repeatability: minimum -0.23 cm/second at C2; maximum -0.58 cm/second at C4). Subgroup analysis regarding anatomic conditions (stenotic vs. nonstenotic segments) and different velocity encoding (2 vs. 3 cm/second) showed comparable results. CONCLUSIONS This study demonstrates good comparability between axial and sagittal spinal cord motion measurements in DCM patients. To this end, axial and sagittal PC-MRI are both accurate and sensitive in detecting pathologic cord motion. Therefore, such measures could identify high-risk patients and improve clinical decision-making (ie, timing of decompression).
Collapse
Affiliation(s)
- Nikolai Pfender
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Jan Rosner
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland,Department of NeurologyBern University HospitalInselspitalUniversity of BernBernSwitzerland
| | - Carl Moritz Zipser
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Susanne Friedl
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Kevin Vallotton
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Reto Sutter
- RadiologyBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | | | - Martin Schubert
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Michael Betz
- University Spine Centre ZurichBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - José Miguel Spirig
- University Spine Centre ZurichBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Maryam Seif
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland,Department of NeurophysicsMax Planck Institute for Human Cognitive and Brain SciencesLeipzigGermany
| | - Michèle Hubli
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Patrick Freund
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Mazda Farshad
- University Spine Centre ZurichBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Armin Curt
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland,University Spine Centre ZurichBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| | - Markus Hupp
- Spinal Cord Injury CenterBalgrist University HospitalUniversity of ZurichZurichSwitzerland
| |
Collapse
|
7
|
Kalsi-Ryan S, Chan C, Verrier M, Curt A, Fehlings M, Bolliger M, Velstra IM. The graded redefined assessment of strength sensibility and prehension version 2 (GV2): Psychometric properties. J Spinal Cord Med 2019; 42:149-157. [PMID: 31573454 PMCID: PMC6781465 DOI: 10.1080/10790268.2019.1616950] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
Context: GRASSP Version 1 (GV1) was developed in 2010, is an upper extremity measure specifically designed to assess recovery after traumatic tetraplegia. A second version was developed to reduce length of the test and refine instructions/standardization. The purpose of this post hoc analysis was to calculate psychometric properties of GRASSP Version 2 (GV2). Design/Setting: A post-hoc analysis of datasets for the GRASSP cross-sectional (n = 72 chronic,) and longitudinal (n = 127 acute) studies was conducted. Reliability, validity and MDD were calculated from the chronic sample and responsiveness was re-calculated from the longitudinal sample. Both studies were observational. Participants: A chronic sample (n = 72) and acute longitudinal sample (n = 127) of individuals with traumatic tetraplegia (AIS A to D, NLI C2 to C8) were studied. Outcome Measures: GV1, the Spinal Cord Independence Measure III (SCIM), International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI) were administered in both studies at all centers and the Capabilities of the Upper Extremity Questionnaire (CUE-Q) was administered in North American sites only. GRASSP-Palmar Sensation, GRASSP-Prehension Performance subtest items included in GV2 were re-analyzed for reliability; validity, MDD and responsiveness. Results: Inter-rater and test-retest reliability for all subtests ranged between 0.849-0.971 and 0.950-0.971 respectively. Concurrent validity between domains of GV2 were positively and moderately (0.530-0.830, P < 0.0001) correlated to SCIM, SCIM self-care subscore (SS) and CUE-Q. MDD values were 4 and 3 points for sensation and prehension performance (single side). Responsiveness values were .84-.88 for GR-Sens and .93-1.22 for GR-PP respectively. Conclusions: GV2 retains excellent psychometric properties as does GV1.
Collapse
Affiliation(s)
- Sukhvinder Kalsi-Ryan
- KITE, Toronto Rehabilitation Institute-UHN, Toronto, Canada,Departtment of Physical Therapy, University of Toronto, Toronto, Canada,Correspondence to: Sukhvinder Kalsi-Ryan, Toronto Rehabilitation Institute, 520 Sutherland Drive, Rehabilitation Engineering Lab-REL, Toronto, Ontario M4G 3V9, Canada.
| | - Colin Chan
- Biomedical Engineering, University of Western Ontario, London, Canada
| | - Mary Verrier
- KITE, Toronto Rehabilitation Institute-UHN, Toronto, Canada,Departtment of Physical Therapy, University of Toronto, Toronto, Canada,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Armin Curt
- Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland
| | - Michael Fehlings
- Department of Surgery, University of Toronto, Toronto, Canada,Krembil Neuroscience Centre, University Health Network, Toronto, Canada
| | - Marc Bolliger
- Spinal Cord Injury Centre, University Hospital Balgrist, Zurich, Switzerland
| | | | | | | |
Collapse
|
8
|
Discrepancy between functional recovery and cutaneous silent period change in surgically treated degenerative cervical myelopathy: a prospective pilot study. Spinal Cord 2019; 57:1076-1083. [DOI: 10.1038/s41393-019-0314-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 06/03/2019] [Accepted: 06/04/2019] [Indexed: 02/05/2023]
|
9
|
Behrman AL, Trimble SA, Argetsinger LC, Roberts MT, Mulcahey MJ, Clayton L, Gregg ME, Lorenz D, Ardolino EM. Interrater Reliability of the Pediatric Neuromuscular Recovery Scale for Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2019; 25:121-131. [PMID: 31068744 DOI: 10.1310/sci2502-121] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background: In synergy with the mounting scientific evidence for the capacity of recovery after spinal cord injury (SCI) and training, new evidence-based therapies advancing neuromuscular recovery are emerging. There is a parallel need for outcome instruments that specifically address recovery. The Pediatric Neuromuscular Recovery Scale (Pediatric NRS) is one example with established content validity to assess neuromuscular capacity within task performance. Objective: The objective of this study was to determine interrater reliability of the Pediatric NRS to classify motor capacity in children after SCI. Methods: Pediatric physicians (3), occupational therapists (5), and physical therapists (6) received standardized training in scoring the scale, then rated video assessments of 32 children post SCI, 2-12 years of age, 78% non-ambulatory. Interrater reliability was analyzed using Kendall coefficient of concordance for individual Pediatric NRS items and overall score. Results: The interrater reliability coefficient was determined to be near 1 for the overall Pediatric NRS score (ICC = 0.966; 95% CI, 0.89-0.98). Twelve of 16 individual items exhibited high concordance coefficients (Kendall's W ≥ 0.8) and four items demonstrated concordance coefficients, < 0.8 and > 0.69. Interrater reliability was equivalent among groups defined by age and neurological level, but lower among non-ambulatory individuals. Conclusion: Strong interrater reliability was demonstrated by pediatric clinicians who scored children with SCI using the Pediatric NRS.
Collapse
Affiliation(s)
- Andrea L Behrman
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Shelley A Trimble
- Spinal Cord Medicine Program, Frazier Rehab Institute, Louisville, Kentucky
| | | | | | - M J Mulcahey
- Jefferson College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Lisa Clayton
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky.,Kosair Charities Center for Pediatric NeuroRecovery, University of Louisville, Louisville, Kentucky
| | - Mary E Gregg
- Department of Biostatistics, University of Louisville, Louisville, Kentucky
| | - Doug Lorenz
- Department of Biostatistics, University of Louisville, Louisville, Kentucky
| | - Elizabeth M Ardolino
- Doctor of Physical Therapy Program - Austin, University of St. Augustine for Health Sciences, Austin, Texas
| |
Collapse
|