TY - JOUR
T1 - Interrater reliability of the international standards for neurological classification of spinal cord injury in youths with chronic spinal cord injury
AU - Mulcahey, Mary Jane
AU - Gaughan, John P.
AU - Chafetz, Ross S.
AU - Vogel, Larry C.
AU - Samdani, Amer F.
AU - Betz, Randal R.
N1 - Funding Information:
Supported by Shriners Hospitals for Children (grant no. 8956 ).
PY - 2011/8
Y1 - 2011/8
N2 - Objectives: To evaluate the interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in children with chronic spinal cord injury (SCI), and to define the lower age limit at which the examinations have clinical utility. Design: Repeated measures, multicenter reliability study. Setting: Two U.S. pediatric specialty hospitals with recognized SCI programs. Participants: Children (N=236) with chronic SCI. Interventions: Subjects underwent 4 examinations by 2 raters: sensory tests (pin prick [PP] and light touch [LT]), a motor test, and a test of anal sensation (AS) and anal contraction (AC). Main Outcome Measures: A 2-way general linear model analysis of variance was used for analysis. Intraclass correlation coefficients (ICCs) and 95% confidence intervals were calculated for PP, LT, motor, AS, and AC. Results: No child younger than 6 years completed the examination. When examined as a function of age, interrater reliability for motor, PP, LT, AS, and AC was moderate (ICC=.89) to high (ICC=.99). There was poor reliability for AS (ICC=.49) in subjects with complete injuries but moderate reliability for all other variables. There was moderate to high reliability for classification of type (tetraplegia/paraplegia) and severity (complete/incomplete) of injury across age groups. Conclusions: The ISNCSCI does not have utility for children younger than 6 years. For children older than 6 years, interrater reliability of PP, LT, and motor examinations is high.
AB - Objectives: To evaluate the interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in children with chronic spinal cord injury (SCI), and to define the lower age limit at which the examinations have clinical utility. Design: Repeated measures, multicenter reliability study. Setting: Two U.S. pediatric specialty hospitals with recognized SCI programs. Participants: Children (N=236) with chronic SCI. Interventions: Subjects underwent 4 examinations by 2 raters: sensory tests (pin prick [PP] and light touch [LT]), a motor test, and a test of anal sensation (AS) and anal contraction (AC). Main Outcome Measures: A 2-way general linear model analysis of variance was used for analysis. Intraclass correlation coefficients (ICCs) and 95% confidence intervals were calculated for PP, LT, motor, AS, and AC. Results: No child younger than 6 years completed the examination. When examined as a function of age, interrater reliability for motor, PP, LT, AS, and AC was moderate (ICC=.89) to high (ICC=.99). There was poor reliability for AS (ICC=.49) in subjects with complete injuries but moderate reliability for all other variables. There was moderate to high reliability for classification of type (tetraplegia/paraplegia) and severity (complete/incomplete) of injury across age groups. Conclusions: The ISNCSCI does not have utility for children younger than 6 years. For children older than 6 years, interrater reliability of PP, LT, and motor examinations is high.
KW - Neurological impairment
KW - Paraplegia
KW - Quadriplegia
KW - Rehabilitation
KW - Tetraplegia
UR - http://www.scopus.com/inward/record.url?scp=79961091517&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2011.03.003
DO - 10.1016/j.apmr.2011.03.003
M3 - Article
C2 - 21807145
AN - SCOPUS:79961091517
SN - 0003-9993
VL - 92
SP - 1264
EP - 1269
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 8
ER -