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).

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 (1wk 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

A total of 67 individuals (N=67) with chronic SCI with complete or incomplete injuries representing 6 groups based upon neurologic level of injury (C1-4, C5-6, C7-T1, T2-T6, T7-T12, and L1-S5) who were English-speaking and aged ≥18 years.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

ISNCSCI neurologic 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 neurologic levels and AIS grades. Overall agreement between the neurologic 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 1 hour to complete, which possibly will limit its widespread use. The results should be replicated in larger samples.