Interrater Reliability of the Neuromuscular Recovery Scale for Spinal Cord Injury

Basso, D. Michele; Velozo, Craig A.; Lorenz, Doug; Suter, Sarah P.; Behrman, Andrea L.

doi:10.1016/j.apmr.2014.11.026

Cited by 18 publications

(14 citation statements)

References 16 publications

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“…Phase 1 represents the lowest measure of capability and Phase 4 represents a return to pre‐injury functional capacity. The NRS has been show to possess good reliability, validity, and responsiveness …”

Section: Resultsmentioning

confidence: 99%

A log rank test for clustered data with informative within‐cluster group size

Gregg

Datta

Lorenz

2018

Statistics in Medicine

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The log rank test is a popular nonparametric test for comparing survival distributions among groups. When data are organized in clusters of potentially correlated observations, adjustments can be made to account for within-cluster dependencies among observations, eg, tests derived from frailty models. Tests for clustered data can be further biased when the number of observations within each cluster and the distribution of groups within cluster are correlated with survival times, phenomena known as informative cluster size and informative within-cluster group size. In this manuscript, we develop a log rank test for clustered data that adjusts for the potentially biasing effect of informative cluster size and within-cluster group size. We provide the results of a simulation study demonstrating that our proposed test remains unbiased under cluster-based informativeness, while other candidate tests not accounting for the clustering structure do not properly maintain size. Furthermore, our test exhibits power advantages under scenarios in which traditional tests are appropriate. We demonstrate an application of our test by comparing time to functional progression between groups defined initial functional status in a spinal cord injury data set.

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Section: Resultsmentioning

confidence: 99%

A log rank test for clustered data with informative within‐cluster group size

Gregg

Datta

Lorenz

2018

Statistics in Medicine

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“…Therefore, the item may actually test the training team's ability to hold a person in the appropriate posture, instead of the person's true ability to maintain this posture. Furthermore, in other studies, 14,15 test-retest and interrater reliabilities were shown to be low for Stand retraining, and most subjects had a ceiling effect for this item.…”

Section: Discussionmentioning

confidence: 93%

Validity of the Neuromuscular Recovery Scale: A Measurement Model Approach

Velozo

Moorhouse

Ardolino

et al. 2015

Archives of Physical Medicine and Rehabilitation

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“…After each task has been tested, the individual receives both an overall phase score, and a total NRS score. 13–14 …”

Section: Classification Of Sci and Measuring Recoverymentioning

confidence: 99%

“…The NRS has been found to have strong test-retest reliability (Spearman correlation coefficients of 0.92–0.99) 16 as well as high inter-rater reliability (Kendall coefficient of concordance ≥0.90). 13 The construct validity of the original NRS was established using Rasch analysis, 17 which revealed that the NRS stratifies individuals with all AIS classifications into 5 distinct strata. No floor or ceiling effects were found for the NRS, and the scale also demonstrated a logical order of item difficulty.…”

Section: Classification Of Sci and Measuring Recoverymentioning

confidence: 99%

Activity-Based Therapy: From Basic Science to Clinical Application for Recovery After Spinal Cord Injury

Behrman

Ardolino

Harkema

2017

Journal of Neurologic Physical Therapy

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Background and Purpose Collaboration between scientists and clinicians effectively accelerated translation of scientific evidence for activity-based therapies (ABT) into rehabilitation. This article addresses the basic scientific findings of activity-dependent plasticity that led to Locomotor Training (LT), an ABT, and its principles to advance recovery in adult and pediatric populations with spinal cord injury (SCI). Expansion to new therapies based on these common principles is highlighted, e.g., epidural stimulation. The article also describes a recently developed measure, the Neuromuscular Recovery Scale (NRS), and its psychometric properties. Summary of Key Points LT has led to recovery of walking in some individuals with motor-incomplete SCI even years after injury. Recent studies resulted in individuals with motor- complete SCI regaining some voluntary movements and standing in the presence of epidural stimulation. The level of success for LT and epidural stimulation appears dependent on spinal networks maintaining the appropriate central state of excitability for the desired task. As these new advances in restorative therapies required an outcome measure that measured performance without compensation, the NRS was developed. The NRS has strong psychometric properties in adults, and a pediatric version is under development. Application of LT in children is still novel. Preliminary evidence suggests that LT can improve trunk control, and also foster participation in children with chronic SCI. Recommendations for Clinical Practice Activity-based therapies may effectively promote neuromuscular recovery, improve function and participation in adults and children post-SCI. Evaluation of outcomes with valid measures, such as the NRS, is necessary to document the ability to perform functional tasks, and to assess progress as function improves.

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Interrater Reliability of the Neuromuscular Recovery Scale for Spinal Cord Injury

Cited by 18 publications

References 16 publications

A log rank test for clustered data with informative within‐cluster group size

A log rank test for clustered data with informative within‐cluster group size

Validity of the Neuromuscular Recovery Scale: A Measurement Model Approach

Activity-Based Therapy: From Basic Science to Clinical Application for Recovery After Spinal Cord Injury

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