Aims: To determine the inter-rater reliability in scoring sensory and motor function and in de®ning sensory and motor levels in incomplete spinal cord injury, using the revised 1992 International Standards for Neurological and Functional Classi®cation of Spinal Cord Injury (ISCSCI-92) and to determine the e ect on raters agreement of one standardising assessment. Methods: Two physicians and two physiotherapists at the Spinal Cord Injury Unit, Karolinska Hospital, classi®ed 23 patients according to the ISCSCI-92. Kappa values were calculated. Results: Kappa values varied from 0 to 0.83 (poor to very good) for the pin-prick scores, from 0 to 1 for the light touch scores and from 0 to 0.89 for motor function after the standardising assessment. Kappa values for sensory and motor levels were fair to poor after the standardising assessment. The results showed improvement in degree of agreement in 35/46 dermatomes for scoring pin-prick, in 15/42 for light touch, in 14/19 segments for motor function and for three out of four sensory and motor levels. Conclusion: This study indicates a weak inter-rater reliability for scoring incomplete SCI lesions using the ISCSCI-92. Spinal Cord (2000) 38, 675 ± 679
Anterior cruciate ligament reconstruction (ACLR) is a commonly performed orthopaedic procedure, and it is crucial to assess an athlete’s readiness to safely return to sports following ACLR in order to minimize the risk of reinjury. Despite this, determining optimal return to play (RTP) criteria following ACLR that is accurate, accessible, and reproducible remains challenging. This review aims to discuss commonly employed RTP criteria domains, including functional assessments, patient-reported outcomes, and psychological tests, as well as emerging technologies such as MRI imaging that may play a role as a gold standard in RTP assessment. The findings of this review suggest return to play decision making after ACL surgery is nuanced and traditionally used objective measures do not perfectly predict RTS rates or clinical outcomes. In the future, a standardized MRI screening tool could help predict reinjury. The role of functional and psychological PROMs needs to defined, and objective criteria should be rigorously evaluated for whether they accurately screen an athlete’s physical readiness and should be expanded to include more sport specific movement analysis.
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