Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with complete spinal cord injury

Mulcahey, M. J.; Gaughan, John; Betz, Randal R.

doi:10.1038/sc.2008.66

Cited by 16 publications

(21 citation statements)

References 12 publications

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“…An ICC of 1 indicates complete agreement; this occurred only in subjects with complete SCI. These findings may have occurred because those muscles that were scored as a 5 (normal) and 0 (paralyzed) were also included in the results; previous reports 10,17 have shown that agreement of repeated testing of unimpaired and completely paralyzed muscles is usually perfect, and for this reason, previous studies have excluded them from analysis. 5 We choose not to exclude myotomes and dermatomes that were unimpaired and completely paralyzed because this would lead to a variable number of myotomes and dermatomes at each level, potentially, leading to skewed data.…”

Section: Discussionmentioning

confidence: 99%

“…Based on our previous work, 10 we hypothesized that, regardless of the American Spinal Injury Association Impairment Scale designation, there would be moderate-to-high agreement for motor scores at individual levels for both inter-and intra-rater reliability. Conversely, for incomplete injuries, we expected agreement of sensory scores at individual levels to be moderate-to-high for intra-rater reliability and only moderate for inter-rater reliability.…”

Section: Purposementioning

confidence: 99%

“…Jonsson et al 2 evaluated the inter-rater reliability of the ISNCSCI (1992 version) by assessing the degree of agreement between sensory and motor scores at individual myotomes and dermatomes in adults with incomplete SCI. Mulcahey et al 10 looked at intra-rater agreement of repeated motor and sensory scores at individual myotomes and dermatomes in the pediatric population with complete SCI.…”

Section: Introductionmentioning

confidence: 99%

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Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with spinal cord injury

et al. 2012

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Study design: A prospective repeated measures multicenter study to determine reliability at individual spinal levels when applied to young persons with spinal cord injury (SCI). Objectives: To evaluate intra-and inter-rater agreement of repeated motor and sensory scores at individual spinal levels. Setting: Shriners Hospitals for Children-Philadelphia and Chicago, USA Methods: A total 189 youth with complete and incomplete SCI underwent four neurological exams by two different raters. Agreement between and within raters for each myotome and dermatome was evaluated for complete and incomplete SCI separately. Intraclass correlation coefficients and 95% confidence intervals were calculated. Results: Overall, both intra-and inter-rater agreement resulted in moderate-to-high agreement among myotomes. Subjects with complete SCI had moderate agreement for light touch (LT) and pin prick (PP) testing, whereas subjects with incomplete SCI had 460.0% of dermatomes resulting in poor agreement for PP testing. Conclusion: Overall, moderate-to-high agreement was found for muscle strength comparisons and moderate-to-poor agreement was found for PP and LT.

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Section: Discussionmentioning

confidence: 99%

Section: Purposementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with spinal cord injury

et al. 2012

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“…2,3,5 This multicentered study was reviewed and approved by the Institutional Review Boards at participating sites. Written informed consent was obtained from parents or legal guardians of all subjects under the age of 18 years old and participants between ages of 7 and 18 completed informed assents.…”

Section: Methodsmentioning

confidence: 99%

The international standards for neurological classification of spinal cord injury: relationship between S4-5 dermatome testing and anorectal testing

et al. 2010

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Study design: Prospective cross-sectional multicenter study. Objective: To evaluate the correlation, sensitivity, specificity and predictive values of S4-5 dermatome and the anorectal examination for determination of sacral sparing in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. Setting: Two tertiary hospitals that specialize in pediatric spinal cord injuries. Methods: In all, 189 patients who were at minimum 3 month after spinal cord injury participated in complete ISNCSCI examinations. All examiners completed training for the proper completion of the ISNCSCI examination. Correlations and sensitivity/specificity analyses were conducted between S4-5 dermatome testing and the anorectal examination. Results were analyzed by age of patient, examiner, tetraplegia/paraplegia classification and injury level (T10-S3, L1-S3 and S3). Results: The correlation between S4-5 dermatome and anorectal sensation was moderate (0.62, Po0.001). Using the anorectal examination as the gold standard, the sensitivity of S4-5 testing was 0.60 (0.49, 70) and specificity was 0.96 (0.90, 0.99). No single age group, tester, level, or type of injury differed from the overall result. Conclusion: In the pediatric population, the correlation between S4-5 and anorectal sensation was lower than anticipated. The sensitivity of 0.62 for S4-5 testing and diminished sensation between T10 and S3 suggests that anorectal testing may either be a more sensitive representation of S4-5 function or activate an alternative neuronal pathway that is perceived by the patient. Further investigation into the validity of the sacral sparing components of the ISNCSCI examination is warranted.

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“…8,[11][12][13] It reports on the derivation of a limited dermatome test based on a principal components analysis (PCA) using 726 full sensory exams with 190 children and youth with SCI.…”

Section: T He International Standards For Neurological Classificationmentioning

confidence: 99%

Using a Limited Number of Dermatomes as a Predictor of the 56-Dermatome Test of the International Standards for Neurological Classification of Spinal Cord Injury in the Pediatric Population

Krisa

Mulcahey

Gaughan

et al. 2013

Topics in Spinal Cord Injury Rehabilitation

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Background: For young children with spinal cord injury (SCI), the sensory exam of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) is long and arduous, often making it impossible to complete. Objectives: In this study, we determine whether an abbreviated sensory exam provides comparable information to the full 56-dermatome exam. Method: A total of 726 56-dermatome sensory exams were completed with 190 children and youth with SCI ranging in age from 3 to 21 years. The cohort was randomly split into test and validation groups. For the test group, a principal component analysis (PCA) was carried out separately for pin prick (PP) and light touch (LT) scores. From the PCA, a hierarchical cluster analysis was performed to identify the most influential set of 4, 8, 12, and 16 dermatomes. From the sensory exam data obtained from the validation group, a linear regression was performed to compare the limited-dermatome composite scores to the total 56-dermatome scores. Results: For both LT and PP, the 16-dermatome test resulted in the best fit (0.86 and 0.87, respectively) with the 56-dermatome test and was comprised of dermatomes from both the left (7 dermatomes) and right (9 dermatomes) sides and at least 1 dermatome from each vertebral region bilaterally (cervical, thoracic, lumbar, sacral). Conclusion: A 16-dermatome sensory exam provided a good correlation to the 56-dermatome exam. The shortened exam may be useful for evaluating children with SCI who cannot tolerate the full examination.

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Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with complete spinal cord injury

Cited by 16 publications

References 12 publications

Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with spinal cord injury

Agreement of repeated motor and sensory scores at individual myotomes and dermatomes in young persons with spinal cord injury

The international standards for neurological classification of spinal cord injury: relationship between S4-5 dermatome testing and anorectal testing

Using a Limited Number of Dermatomes as a Predictor of the 56-Dermatome Test of the International Standards for Neurological Classification of Spinal Cord Injury in the Pediatric Population

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