Validity and Reliability of Interview and Online Self-Report Versions of Motor and Sensory Components of a Neurological Exam for Classifying Spinal Cord Injury (One-SCI).

Abstract

Objective: To examine the feasibility, validity, and reliability of the Online Neurological Exam for Spinal Cord Injury (One-SCI), a patient-reported outcome measure of the motor and sensory components needed for classifying spinal cord injury (SCI) according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) DESIGN: Repeat administration (one week interval) of either an online self-administered or an interviewer-administered survey (both supported by extensive computer-provided illustrations and animations) followed by an in-person ISNCSCI examination after an additional week SETTING: Academic free standing rehabilitation center and medical center PARTICIPANTS: 67 individuals with chronic SCI with complete or incomplete injuries representing six groups based upon neurological level of injury (C1-4, C5-6, C7-T1, T2-T6, T7-T12, and L1-S5) who were English-speaking and aged 18 or older INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: ISNCSCI neurological levels and American Spinal Injury Association Impairment Scale (AIS) grade RESULTS: Overall test-retest agreement was substantial, with kappas ranging from 0.69 to 0.84 for all the neurological levels and AIS grades. Overall agreement between the neurological levels and AIS grades derived from the first administration of One-SCI (participant survey responses) and the ISNCSCI examinations was moderate to substantial, with kappas ranging from 0.55 to 0.71. The median time needed to complete the interview and online versions of One-SCI the first time was 51 minutes.

Conclusions: Findings generally support the reliability and validity of both interview and online versions of One-SCI. One-SCI does take nearly one hour to complete, which possibly will limit its widespread use. The results should be replicated in larger samples.