Citation

Basso DM, Velozo C, Lorenz D, Suter S, Behrman AL. Arch. Phys. Med. Rehabil. 2014; 96(8): 1397-1403.

Affiliation

University of Louisville, Department of Neurological Surgery and Kentucky Spinal Cord Injury Research Center, Louisville, KY.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.apmr.2014.11.026

PMID

25546720

Abstract

OBJECTIVE: To determine the inter-rater reliability of the Neuromuscular Recovery Scale (NRS) an outcome measure designed for spinal cord injury (SCI). The scale classifies people with complete or incomplete SCI into four phase of injury groups exhibiting reduced variability in measures of balance, gait speed and walking. The NRS, which assesses motor performance based on normal, pre-injury function disallowing use of compensation, includes 4 treadmill-based items, 6 overground/mat items and an overall rating. Outcomes range from 1-4 with up to 3 subclassifications (A, B, C). Higher ratings reflect greater recovery of normal function.

DESIGN: Masked comparison, multi-center observational study SETTING: Outpatient rehabilitation PARTICIPANTS: Fourteen raters and a criterion standard expert assigned scores to 10 video NRS assessments of persons with SCI. The raters were volunteers from the NeuroRecovery Network. INTERVENTION: Not applicable Main outcome measure: Inter-rater reliability measured with Kendall's coefficient of concordance (W) RESULTS: Inter-rater reliability was generally strong (W: 0.91-0.98; CI: 0.65-0.99) while lower reliability occurred for treadmill stand retraining (W: 0.87; CI: 0.06, 1) and seated trunk extension (W: 0.82; CI: 0.28, 0.94). Less experienced raters assigned slightly lower scores than the expert for most items but the difference was less than half a point and did not weaken concordance.

CONCLUSIONS: NRS had strong inter-rater reliability, a necessary first step in establishing its utility as a clinical and research outcome measure.

Language: en