Theoretical and practical training improves knowledge of the examination guidelines of the International Standards for Neurological Classification of Spinal Cord Injury

Abstract

Study design Prospective pre–post study. Objectives International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) represents the most frequently used assessment to determine the level and severity of a spinal cord injury (SCI). The guidelines for ISNCSCI are complex and challenging. Knowledge of its correct execution needs to be imparted precisely. The aim of this study was to investigate whether hands-on instructional courses can increase the knowledge of the ISNCSCI examination guidelines. Setting European Multicenter Study about SCI. Methods Before and after the instructional courses, participants were asked to complete questionnaires. The set of questions covered the most important aspects of the examination guidelines. Attendees were asked to self-rate their occupation and experience in ISNCSCI. Results The comparison of pretest and posttest results of 164 attendees from 2014 to 2018 revealed an improvement of knowledge reflected by an increase of correct answers from 66 ± 17% before to 89 ± 11% after the course (p < 0.01). The improvement was not associated with occupation (p > 0.1). However, the correctness of pretest results differed concerning both the period of experience with ISNCSCI (p < 0.05) and the course language (p < 0.01), while the frequency of execution resulted in differences in the posttest (p = 0.01). Conclusions Instructional courses substantially improve knowledge of the ISNCSCI examination guidelines. Differences in knowledge present before the course leveled off after the course. Comprehensive theoretical training is strongly recommended to ensure reliability and validity of ISNCSCI examinations in clinical routine and research. Albeit being practiced in the instructional courses, the benefit of hands-on training still needs to be systematically evaluated in future studies.

Noxious radiant heat evokes bi-component nociceptive withdrawal reflexes in spinal cord injured humans—A clinical tool to study neuroplastic changes of spinal neural circuits

“…Participants with SCI were neurologically examined and classified according to the 7th edition of the International Standards for Neurological Classification of SCI (ISNCSCI) by expertly trained assessors ( Kirshblum et al, 2011 ; Schuld et al, 2013 ; Franz et al, 2022 ).…”

Impact of Heterotopic Ossification on Functional Recovery in Acute Spinal Cord Injury

“…These comprise neurological examinations according to the “International Standards for Neurological Classification of Spinal Cord Injury” (ISNCSCI; Kirshblum et al, 2011 ; American Spinal Injury Association, 2019 ) and functional tests, such as the Spinal Cord Independence Measure (SCIM; Catz et al, 1997 ; Catz and Itzkovich, 2007 ). Data were collected by expertly trained examiners to ensure high quality standards (Curt et al, 2004 ; Schuld et al, 2013 ; Franz et al, 2022 ). Data collection and management were coordinated by means of the in-house established EMSCI database (Rupp et al, 2005 ).…”

Revisiting the Examination of Sharp/Dull Discrimination as Clinical Measure of Spinothalamic Tract Integrity

“…The structure of the manuscript is in accordance with the guidelines for reporting reliability and agreement studies (GRRAS) (21). To ensure current quality standards, all raters were trained within the European Multicenter about Spinal Cord Injury (EMSCI) (22)(23)(24) network according to the 7 th ISNCSCI edition updated in 2015 (25).…”