Journal of Spinal Cord Medicine最新文献

{"title":"Elucidating mechanisms of attenuated skin vasodilation during passive heat stress in persons with spinal cord injury.","authors":"Michelle Trbovich, Yubo Wu, Wouker Koek, Jill Wecht, Dean Kellogg","doi":"10.1080/10790268.2023.2203535","DOIUrl":"10.1080/10790268.2023.2203535","url":null,"abstract":"<p><strong>Objective: </strong>Persons with spinal cord injury (SCI) are unable to efficiently dissipate heat via thermoregulatory vasodilation as efficiently as able-bodied persons during whole body passive heat stress (PHS). Skin blood flow (SkBF) is controlled by dual sympathetic vasomotor systems: noradrenergic vasoconstrictor (VC) nerves and cholinergic vasodilator (VD) nerves. Thus, impaired vasodilation could result from inappropriate increases in noradrenergic VC tone that compete with cholinergic vasodilation or diminished cholinergic tone. To address this issue, we used bretylium (BR) which selectively blocks neural release of norepinephrine, thereby reducing noradrenergic VC tone. If impaired vasodilation during PHS is due to inappropriate increase in VC tone, BR treatment will improve SkBF responses during PHS.</p><p><strong>Design: </strong>Prospective interventional trial.</p><p><strong>Setting: </strong>laboratory.</p><p><strong>Participants: </strong>22 veterans with SCI.</p><p><strong>Interventions: </strong>Skin surface areas with previously defined intact vs. impaired thermoregulatory vasodilation were treated with BR iontophoresis with a nearby untreated site serving as control/CON. Participants underwent PHS until core temperature rose 1°C.</p><p><strong>Outcome measures: </strong>Laser doppler flowmeters measured SkBF over BR and CON sites in areas with impaired and intact thermoregulatory vasodilation. Cutaneous vascular conductance (CVC) was calculated for all sites. Peak-PHS CVC was normalized to baseline (BL): (CVC peak-PHS/CVC BL) to quantify SkBF change.</p><p><strong>Results: </strong>CVC rise in BR sites was significantly less than CON sites in areas with intact (<i>P</i> = 0.03) and impaired (<i>P</i> = 0.04) thermoregulatory vasodilation.</p><p><strong>Conclusion: </strong>Cutaneous blockade of neural release of noradrenergic neurotransmitters affecting vasoconstriction did not enhance thermoregulatory vasodilation during PHS in persons with SCI; rather BR attenuated the response. Cutaneous blockade of neural release of noradrenergic neurotransmitters affecting vasoconstriction did not restore cutaneous active vasodilation during PHS in persons with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"765-774"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378667/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does stronger primary care improve access to health services for persons with spinal cord injury? Evidence from eleven European countries.","authors":"Olena Bychkovska, Piotr Tederko, Vegard Strøm, Alvydas Juocevicius, Armin Gemperli","doi":"10.1080/10790268.2023.2188390","DOIUrl":"10.1080/10790268.2023.2188390","url":null,"abstract":"<p><strong>Objective: </strong>To determine the association between the strength of primary care and perceived access to follow-up care services among persons with chronic spinal cord injury (SCI).</p><p><strong>Design: </strong>Data analysis of the International Spinal Cord Injury (InSCI) cross-sectional, community-based questionnaire survey conducted in 2017-2019. The association between the strength of primary care (Kringos <i>et al</i>., 2003) and access to health services was established using univariable and multivariable logistic regression analysis, adjusted for socio-demographic and health status characteristics.</p><p><strong>Setting: </strong>Community in eleven European countries: France, Germany, Greece, Italy, Lithuania, the Netherlands, Norway, Poland, Romania, Spain and Switzerland.</p><p><strong>Participants: </strong>6658 adults with chronic SCI.</p><p><strong>Intervention: </strong>None.</p><p><strong>Outcome measures: </strong>Share of persons with SCI that reported unmet healthcare needs as a measure of access.</p><p><strong>Results: </strong>Twelve percent of the participants reported unmet healthcare needs: the highest in Poland (25%) and lowest in Switzerland and Spain (7%). The most prevalent access restriction was service unavailability (7%). Stronger primary care was associated with lower odds of reporting unmet healthcare needs, service unavailability, unaffordability and unacceptability. Females, persons of younger age and lower health status, had higher odds of reporting unmet needs.</p><p><strong>Conclusions: </strong>In all investigated countries, persons with chronic SCI face access barriers, especially with service availability. Stronger primary care for the general population was also associated with better health service access for persons with SCI, which argues for further primary care strengthening.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"701-711"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9177300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do all patients with functional motor-incomplete (AIS-D) traumatic spinal cord injury need specialized inpatient functional rehabilitation? <i>A prospective observational cohort study proposing clinical criteria for home-based rehabilitation after acute care</i>.","authors":"Andréane Richard-Denis, Antoine Dionne, Pascal Mputu Mputu, Jean-Marc Mac-Thiong","doi":"10.1080/10790268.2023.2200354","DOIUrl":"10.1080/10790268.2023.2200354","url":null,"abstract":"<p><strong>Context/objective: </strong>Functional motor-incomplete AIS-D traumatic spinal cord injury (tSCI) represents an important growing population in neuro-traumatology. There is thus an important need for establishing strategies to optimize SCI rehabilitation resources. This study aims at proposing eligibility criteria to select individuals who could be discharged home (home-based rehabilitation) after acute care following an AIS-D tSCI and investigate its impact on the long-term functional status and quality of life (QOL), as compared to transfer to inpatient functional rehabilitation (IFR) resources.</p><p><strong>Design: </strong>An observational prospective cohort study.</p><p><strong>Setting: </strong>A single Level-1 specialized trauma center.</p><p><strong>Participants: </strong>213 individuals sustaining an AIS-D tSCI.</p><p><strong>Interventions: </strong>Home-based rehabilitation based on clinical specific criteria to be assessed by the acute care team.</p><p><strong>Outcome measures: </strong>Functional status and QOL as assessed by the Spinal Cord Independence Measure version 3 and WHOQOL-BREF questionnaire one year following the injury, respectively.</p><p><strong>Results: </strong>A total 37.9% of individuals fulfilled proposed criteria for home-based rehabilitation after acute care. As expected, this group was significantly younger, experienced lesser comorbidities and acute complications, and showed higher motor and sensory function compared to the IFR group. Home-rehabilitation was associated with a higher long-term functional status, physical and psychological QOL, when accounting for relevant confounding factors after an acute AIS-D tSCI<i>.</i> There was no readmission due to failure of home-based rehabilitation.</p><p><strong>Conclusion: </strong>Home-based rehabilitation in selected individuals sustaining an acute AIS-D tSCI is a safe and interesting strategy to optimize the long-term outcome in terms of functional recovery, physical and psychological QOL, as well as to optimize inpatient rehabilitation resources. The proposed eligibility criteria can be used by the acute care team to select the optimal discharge orientation in this important subpopulation.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"753-764"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378677/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9774744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potentially harmful drug-drug interactions in the therapeutic regimens of persons with spinal cord injury.","authors":"Shikha Gupta, Alaina Dhawan, Jillian Dhawan, Mary Ann McColl, Karen M Smith, Alexander McColl","doi":"10.1080/10790268.2023.2185399","DOIUrl":"10.1080/10790268.2023.2185399","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals with spinal cord injury deal with multiple health complications that require them to use many medications. The purpose of this paper was to find the most common potentially harmful drug-drug interactions (DDIs) in therapeutic regimens of persons with spinal cord injury, and the risk factors associated with it. We further highlight the relevance of each of the DDIs specific to spinal cord injury population.</p><p><strong>Design: </strong>Observational design and cross-sectional analysis.</p><p><strong>Setting: </strong>Community; Canada.</p><p><strong>Participants: </strong>Individuals with spinal cord injury (<i>n</i> = 108).</p><p><strong>Main outcome measures/analysis: </strong>The main outcome was the presence of one or more potential DDIs that can lead to an adverse outcome. All the reported drugs were classified as per the World Health Organization's Anatomical Therapeutic Chemical Classification system. Twenty potential DDIs were selected for the analysis based on the most common medications prescribed to people with spinal cord injury and severity of clinical consequences. The medication lists of study participants were analyzed for selected DDIs.</p><p><strong>Results: </strong>Among the 20 potential DDIs analyzed in our sample, the top 3 prevalent DDIs were Opioids + Skeletal Muscle Relaxants, Opioids + Gabapentinoids, and Benzodiazepines + ≥ 2 other central nervous system (CNS)-active drugs. Of the total sample of 108 respondents, 31 participants (29%) were identified with having at least one potential DDI. The risk of having a potential DDI was highly associated with polypharmacy, though no associations were found between the presence of a drug interaction and age, sex, level of injury, time since injury, or cause of injury among the study sample.</p><p><strong>Conclusion: </strong>Almost three out of ten individuals with spinal cord injury were at risk of having a potentially harmful drug interaction. Clinical and communication tools are needed that facilitate identification and elimination of harmful drug combinations in the therapeutic regimens of patients with spinal cord injury.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"692-700"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9170727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Researching the risks for cardiovascular disease after spinal cord injury: The Ernest Bors, MD award for scientific development.","authors":"Florian P Thomas, Carolann Murphy","doi":"10.1080/10790268.2024.2393053","DOIUrl":"10.1080/10790268.2024.2393053","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":"47 5","pages":"613-614"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wheelchair users' satisfaction after provision using the WHO 8-step guidelines: A pilot study.","authors":"Ivett Quiñones-Uriostegui, Aldo Alessi-Montero, Virginia Bueyes-Roiz, Lidia Nuñez-Carrera, Ana Moreno-Hernández, Jimena Quinzaños-Fresnedo, Gerardo Rodríguez-Reyes","doi":"10.1080/10790268.2023.2171627","DOIUrl":"10.1080/10790268.2023.2171627","url":null,"abstract":"<p><strong>Background: </strong>Wheelchairs are vital for the successful rehabilitation and inclusion of people with mobility disabilities; 10% of the population with disabilities needs a wheelchair, but only 15% have access to an adequate one. Not user-configured wheelchairs may lead to postural deformities and pressure ulcers, thus negatively impact user satisfaction, wheelchair skills, and quality of life.</p><p><strong>Objective: </strong>To assess the impact of the 8-step \"Guidelines on the provision of manual wheelchairs in less-resourced settings\" from the World Health Organization (WHO) on user satisfaction, wheelchair skills, and quality of life of Mexican manual wheelchair users.</p><p><strong>Methods: </strong>12 wheelchair users with spinal cord injury that received rehabilitation were recruited. Volunteers were provided a wheelchair and cushion following the WHO 8-step guidelines. Assessment of QUEST, WHOQOL-Bref, and WST-Q was performed at the beginning of the study and 12 months later.</p><p><strong>Results: </strong>Significant improvement was observed in terms of satisfaction (QUEST; P = 0.009) after receiving the wheelchair and the foam cushion (QUEST; P = 0.004). WHOQol-Bref did not denote significant differences. For the dimensions assessed by the WST-Q scores, a significant 10.9% improvement was observed in both, capacity (P = 0.022) and performance (P = 0.009).</p><p><strong>Conclusions: </strong>The application of the WHO 8-step guidelines for wheelchair provision may contribute to increase user satisfaction regarding the wheelchair and cushion devices as well as the prescription process as determined by the QUEST. According to the WST-Q, functional capacity and mobility may also be improved by following the 8-step guidelines.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"640-648"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9633854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term prediction of functional independence using adjusted and unadjusted single items of the functional independence measure (FIM) at discharge from rehabilitation.","authors":"Alejandro García-Rudolph, Mark Wright, Loreto García, Joan Sauri, Blanca Cegarra, Josep Maria Tormos, Eloy Opisso","doi":"10.1080/10790268.2023.2183326","DOIUrl":"10.1080/10790268.2023.2183326","url":null,"abstract":"<p><strong>Context: </strong>Being able to survive in the long-term independently is of concern to patients with spinal cord injury (SCI), their relatives, and to those providing or planning health care, especially at rehabilitation discharge. Most previous studies have attempted to predict functional dependency in activities of daily living within one year after injury<b>.</b></p><p><strong>Objectives: </strong>(1) build 18 different predictive models, each model using one FIM (Functional Independence Measure) item, assessed at discharge, as independent predictor of total FIM score at chronic phase (3-6 years post-injury) (2) build three different predictive models, using in each model an item from a different FIM domain with the highest predictive power obtained in objective (1) to predict \"good\" functional independence at chronic phase and (3) adjust the 3 models from objective (2) with known confounding factors.</p><p><strong>Methods: </strong>This observational study included 461 patients admitted to rehabilitation between 2009 and 2019. We applied regression models to predict total FIM score and \"good\" functional independence (FIM motor score ≥ 65) reporting adjusted <i>R</i>², odds ratios, ROC-AUC (95% CI) tested using 10-fold cross-validation.</p><p><strong>Results: </strong>The top three predictors, each from a different FIM domain, were Toilet (adjusted <i>R</i>² = 0.53, Transfers domain), Toileting (adjusted <i>R</i>² = 0.46, Self-care domain), and Bowel (adjusted <i>R</i>² = 0.35, Sphincter control domain). These three items were also predictors of \"good\" functional independence (AUC: 0.84-0.87) and their predictive power increased (AUC: 0.88-0.93) when adjusted by age, paraplegia, time since injury, and length of stay.</p><p><strong>Conclusions: </strong>Discharge FIM items accurately predict long-term functional independence.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"649-660"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9456344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect of valproic acid on ischemia-reperfusion induced spinal cord injury in a rat model.","authors":"Oya Akpinar Oruc, Mehmet Gazi Boyaci, Şerife Ozdinc, Sefa Celik, Esra Aslan","doi":"10.1080/10790268.2023.2257854","DOIUrl":"10.1080/10790268.2023.2257854","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to determine the anti-inflammatory, antioxidant, and anti-apoptotic effects of valproic acid (VPA) on rat spinal cord tissue in ischemia-reperfusion (IR) injury model created by abdominal aorta occlusion.</p><p><strong>Materials and methods: </strong>Sprague Dawley rat (male sex) weighing 190-260 g divided into four experimental groups: control only underwent laparotomy, sham group, pre-IR injury (200 mg/kg dose), and post-IR injury (300 mg/kg) VPA. We measured serum levels of TNF-<i>α</i>, IL-6, IL-1<i>β</i>, IL-18, Total Oxidant Status (TOS) and Total Antioxidant Status (TAS), and serum Oxidative Stress Index (OSI) ratio, and tissue expression of Bax and Bcl2, Caspase3, and Bax/Bcl2 ratio.</p><p><strong>Results: </strong>Serum IL-18 was higher in the sham than the control group(<i>P</i> = 0.001), and there were declines in the pre-IR treatment (<i>P</i> = 0.002) and the post-IR treatment when compared to sham (<i>P</i> = 0.001). Despite these reductions, IL-18 expression levels in both the pre- and post-IR treatment groups were higher than in the control group (<i>P</i> = 0.001 & <i>P</i> = 0.003). The favorable effects of pre-IR VPA administration on immunohistochemical biomarkers were superior to post-IR VPA administration.</p><p><strong>Conclusions: </strong>Comparative analyses between prophylactic VPA administration and post-IR interventions revealed congruence in their anti-inflammatory and anti-apoptotic ramifications. VPA can reduce spinal cord IR injury in an aortic occlusion model of rats.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"775-782"},"PeriodicalIF":16.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136400096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SCI Thrive: Impact of a peer-led online self-management program.","authors":"Jeanne M Hoffman, Chris Garbaccio, Shannon Tyman, Jayden Chapman, Daniel Gray, Amy J Starosta","doi":"10.1080/10790268.2023.2192852","DOIUrl":"10.1080/10790268.2023.2192852","url":null,"abstract":"<p><strong>Objective: </strong>To test the effectiveness of a peer-led online self-management program for individuals with spinal cord injury (SCI).</p><p><strong>Design: </strong>Randomized waitlist control trial.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>184 adults with SCI.</p><p><strong>Interventions: </strong>SCI Thrive is a peer-led self-management program with self-paced online content and video-sessions for live discussion.</p><p><strong>Outcome measures: </strong>Perceived quality of life, self-efficacy for health, participation.</p><p><strong>Results: </strong>A total of 97 individuals (86 randomized plus 9 assigned to the final group) were assigned to treatment and 86 randomized to the waitlist. Participants were 51 years old on average (SD = 14.9), with 58% male, mean of 15.5 (SD = 14.0) years injured, with 59% cervical injuries and 64% incomplete injuries. The treatment group had significantly higher scores on CHART occupational subscale (P = .022), but no other differences were found at the end of 6 weeks. Analysis of all participants who completed SCI Thrive showed significant increase in self-efficacy between baseline (6.32) and 6 weeks (6.81; P < .001) which was maintained at 3 months post treatment (6.83; P = .001). Those who were more engaged in SCI Thrive reported higher quality of life (P = .001), self-efficacy (P = .007), and increased mobility on the CHART (P = .026).</p><p><strong>Conclusion: </strong>SCI Thrive is a highly accessible program for individuals with SCI and shows promise for improving self-efficacy. Strategies to increase engagement should be added to maximize benefits. Measurement tools may have been impacted by COVID-19 pandemic. Further research on the efficacy of SCI Thrive is needed given feedback on benefit of a group focus area, such as on physical activity.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"723-732"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9214343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-center international study on the spinal cord independence measure, version IV: Rasch psychometric validation.","authors":"Amiram Catz, Malka Itzkovich, Rotem Rozenblum, Keren Elkayam, Adi Kfir, Luigi Tesio, Harvinder Singh Chhabra, Dianne Michaeli, Gabi Zeilig, Einat Engel-Haber, Emiliana Bizzarini, Claudio Pilati, Salvatore Stigliano, Marcella Merafina, Giulio Del Popolo, Gabriele Righi, Jacopo Bonavita, Ilaria Baroncini, Nan Liu, Huayi Xing, Paulo Margalho, Ines Campos, Marcelo Riberto, Thabata Pasquini Soeira, Bobeena Chandy, George Tharion, Mrinal Joshi, Jean-François Lemay, Marie-Thérèse Laramée, Dorothyann Curran, Annelie Schedin Leiulfsrud, Linda Sørensen, Fin Biering-Sorensen, Henrik Hagen Poder, Nur Kesiktas, Lisa Burgess-Collins, Jayne Edwards, Aheed Osman, Vadim Bluvshtein","doi":"10.1080/10790268.2023.2183334","DOIUrl":"10.1080/10790268.2023.2183334","url":null,"abstract":"<p><strong>Context: </strong>The Spinal Cord Independence Measure is a comprehensive functional rating scale for individuals with spinal cord lesion (SCL).</p><p><strong>Objective: </strong>To validate the scores of the three subscales of SCIM IV, the fourth version of SCIM, using advanced statistical methods.</p><p><strong>Study design: </strong>Multi-center cohort study.</p><p><strong>Setting: </strong>Nineteen SCL units in 11 countries.</p><p><strong>Methods: </strong>SCIM developers created SCIM IV following comments by experts, included more accurate definitions of scoring criteria in the SCIM IV form, and adjusted it to assess specific conditions or situations that the third version, SCIM III, does not address. Professional staff members assessed 648 SCL inpatients, using SCIM IV and SCIM III, at admission to rehabilitation, and at discharge. The authors examined the validity and reliability of SCIM IV subscale scores using Rasch analysis.</p><p><strong>Results: </strong>The study included inpatients aged 16-87 years old. SCIM IV subscale scores fit the Rasch model. All item infit and most item outfit mean-square indices were below 1.4; statistically distinct strata of abilities were 2.6-6; most categories were properly ordered; item hierarchy was stable across most clinical subgroups and countries. In a few items, however, we found misfit or category threshold disordering. We found SCIM III and SCIM IV Rasch properties to be comparable.</p><p><strong>Conclusions: </strong>Rasch analysis suggests that the scores of each SCIM IV subscale are reliable and valid. This reinforces the justification for using SCIM IV in clinical practice and research.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"681-691"},"PeriodicalIF":1.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9220639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}