TY - JOUR
T1 - Reliability and validity of the international standards for neurological classification of spinal cord injury in patients with non-traumatic spinal cord lesions
AU - Lena, Emanuela
AU - Baroncini, Ilaria
AU - Pavese, Chiara
AU - Musumeci, Gaia
AU - Volini, Silvia
AU - Masciullo, Marcella
AU - Aiachini, Beatrice
AU - Fizzotti, Gabriella
AU - Puci, Mariangela V.
AU - Scivoletto, Giorgio
N1 - Funding Information:
Funding The paper is partially supported by the ERANET-NEURON grant to Giorgio Scivoletto.
Publisher Copyright:
© 2021, The Author(s), under exclusive licence to International Spinal Cord Society.
PY - 2021
Y1 - 2021
N2 - Study design: Prospective, observational study. Objectives: The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represent the gold standard for the assessment of patients with spinal cord injury (SCI) and their measurement properties have been evaluated in patients with traumatic lesions. Albeit the ISNCSCI are widely used also for the assessment and prognosis of patients with non-traumatic SCI, a validation of this grading system in this sample has never been performed. Therefore, the aim of this study is to evaluate the measurement properties of the ISNCSCI in a population of persons with non-traumatic SCI. Setting: Three Italian rehabilitation hospitals. Methods: The sample included 140 patients with non-traumatic SCI of different etiology, level and grade, for a total of 169 evaluations performed by two examiners. Cronbach’s Alpha was used to evaluate the internal consistency of the ISNCSCI various components. The agreement between two examiners of each center in the definition of different components was used to assess the inter-rater reliability. The construct validity was evaluated through the correlation of the ISNCSCI with the Spinal Cord Independence Measure (SCIM). Results: The ISNCSCI showed substantial internal consistency, and substantial inter-rater agreement for AIS grade, cumulative motor and sensory scores. The motor scores for upper and lower extremity showed fair to moderate correlation with SCIM self-care and motility subscores, respectively. The ISNCSCI total motor score correlated with the total SCIM score. Conclusions: Our study demonstrates that the ISNCSCI are a valid and reliable tool for the assessment of patients with non-traumatic SCI.
AB - Study design: Prospective, observational study. Objectives: The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represent the gold standard for the assessment of patients with spinal cord injury (SCI) and their measurement properties have been evaluated in patients with traumatic lesions. Albeit the ISNCSCI are widely used also for the assessment and prognosis of patients with non-traumatic SCI, a validation of this grading system in this sample has never been performed. Therefore, the aim of this study is to evaluate the measurement properties of the ISNCSCI in a population of persons with non-traumatic SCI. Setting: Three Italian rehabilitation hospitals. Methods: The sample included 140 patients with non-traumatic SCI of different etiology, level and grade, for a total of 169 evaluations performed by two examiners. Cronbach’s Alpha was used to evaluate the internal consistency of the ISNCSCI various components. The agreement between two examiners of each center in the definition of different components was used to assess the inter-rater reliability. The construct validity was evaluated through the correlation of the ISNCSCI with the Spinal Cord Independence Measure (SCIM). Results: The ISNCSCI showed substantial internal consistency, and substantial inter-rater agreement for AIS grade, cumulative motor and sensory scores. The motor scores for upper and lower extremity showed fair to moderate correlation with SCIM self-care and motility subscores, respectively. The ISNCSCI total motor score correlated with the total SCIM score. Conclusions: Our study demonstrates that the ISNCSCI are a valid and reliable tool for the assessment of patients with non-traumatic SCI.
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U2 - 10.1038/s41393-021-00675-9
DO - 10.1038/s41393-021-00675-9
M3 - Article
AN - SCOPUS:85111647010
JO - Spinal Cord
JF - Spinal Cord
SN - 1362-4393
ER -