Shriners Hospitals for Children, 3551 N. Broad Street, Philadelphia, PA 19140, USA.
Arch Phys Med Rehabil. 2011 Aug;92(8):1264-9. doi: 10.1016/j.apmr.2011.03.003.
To evaluate the interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) in children with chronic spinal cord injury (SCI), and to define the lower age limit at which the examinations have clinical utility.
Repeated measures, multicenter reliability study.
Two U.S. pediatric specialty hospitals with recognized SCI programs.
Children (N=236) with chronic SCI.
Subjects underwent 4 examinations by 2 raters: sensory tests (pin prick [PP] and light touch [LT]), a motor test, and a test of anal sensation (AS) and anal contraction (AC).
A 2-way general linear model analysis of variance was used for analysis. Intraclass correlation coefficients (ICCs) and 95% confidence intervals were calculated for PP, LT, motor, AS, and AC.
No child younger than 6 years completed the examination. When examined as a function of age, interrater reliability for motor, PP, LT, AS, and AC was moderate (ICC=.89) to high (ICC=.99). There was poor reliability for AS (ICC=.49) in subjects with complete injuries but moderate reliability for all other variables. There was moderate to high reliability for classification of type (tetraplegia/paraplegia) and severity (complete/incomplete) of injury across age groups.
The ISNCSCI does not have utility for children younger than 6 years. For children older than 6 years, interrater reliability of PP, LT, and motor examinations is high.
评估国际脊髓损伤神经分类标准（ISNCSCI）在慢性脊髓损伤（SCI）儿童中的评定者间信度，并确定该检查具有临床应用价值的最低年龄。
重复测量、多中心可靠性研究。
具有公认的 SCI 项目的 2 家美国儿科专科医院。
慢性 SCI 儿童（N=236）。
受试者由 2 位评定者进行 4 次检查：感觉检查（针刺觉[PP]和轻触觉[LT]）、运动检查以及肛门感觉（AS）和肛门收缩（AC）检查。
采用 2 路方差分析的广义线性模型进行分析。计算了 PP、LT、运动、AS 和 AC 的组内相关系数（ICC）和 95%置信区间。
没有年龄小于 6 岁的儿童完成检查。按年龄进行检查时，运动、PP、LT、AS 和 AC 的评定者间信度为中度（ICC=.89）到高度（ICC=.99）。完全性损伤患者的 AS 可靠性较差（ICC=.49），但其他所有变量的可靠性均为中度。各年龄组的损伤类型（四肢瘫/截瘫）和严重程度（完全性/不完全性）的分类具有中等到高度的可靠性。
ISNCSCI 对于年龄小于 6 岁的儿童没有应用价值。对于年龄大于 6 岁的儿童，PP、LT 和运动检查的评定者间信度较高。
