The development of an outcome measures toolkit for spinal cord injury rehabilitation

Background. Spinal cord injury (SCI) is a complex medical condition that can be difficult to monitor. Purpose. This study aimed to establish a common set of validated outcome measures specifically for SCI clinical practice. Method. In a three-round online Delphi process, experts in SCI care across Canada suggested and ranked outcome measures for clinical practice. The facilitators provided feedback between rounds and determined if consensus (at least 75% agreement) was reached on a single outcome measure per clinical area. Findings. One hundred and forty-eight outcome measures were initially considered for inclusion. After three rounds, consensus was reached for 23 out of 30 clinical areas. In the remaining seven, more than one outcome measure was recommended. The final toolkit comprises 33 outcome measures with sufficient measurement properties for use with a SCI population. Implications. An outcome measures toolkit validated specifically for SCI should lead to improved identification of best practice and enable clinicians to monitor client progress effectively.

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Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽

10.1038/s41393-021-00693-7 ◽

2021 ◽

Author(s):

Helge Kasch ◽

Uffe Schou Løve ◽

Anette Bach Jønsson ◽

Kaare Eg Severinsen ◽

Marc Possover ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measures ◽

Outcome Measure ◽

Secondary Outcome ◽

Controlled Study ◽

Control Group ◽

Walking Ability ◽

Data Set ◽

Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

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A systematic review of outcome measures in initial rehabilitation of individuals with newly acquired spinal cord injury: providing evidence for clinical practice guidelines

European Journal of Physical and Rehabilitation Medicine ◽

10.23736/s1973-9087.19.05676-4 ◽

2019 ◽

Vol 55 (5) ◽

Author(s):

Rebecca Tomaschek ◽

Armin Gemperli ◽

Rüdiger Rupp ◽

Veronika Geng ◽

Anke Scheel-Sailer ◽

...

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Practice ◽

Outcome Measures ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Cord Injury

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Outcome Measures of Free-Living Activity in Spinal Cord Injury Rehabilitation

Current Physical Medicine and Rehabilitation Reports ◽

10.1007/s40141-019-00228-5 ◽

2019 ◽

Vol 7 (3) ◽

pp. 284-289

Author(s):

Brianna M. Goodwin ◽

Emma Fortune ◽

Meegan G. Van Straaten ◽

Melissa M. B. Morrow

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measures ◽

Free Living ◽

Injury Rehabilitation ◽

Cord Injury

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Measurement properties of the wheelchair outcome measure in individuals with spinal cord injury

Spinal Cord ◽

10.1038/sc.2011.45 ◽

2011 ◽

Vol 49 (9) ◽

pp. 995-1000 ◽

Cited By ~ 17

Author(s):

W C Miller ◽

J Garden ◽

W B Mortenson

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measure ◽

Measurement Properties ◽

Cord Injury

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A Systematic Review of the Measurement Properties of Patient-Reported Outcome Measures in Spinal Cord Injury

Global Spine Journal ◽

10.1055/s-0036-1582941 ◽

2016 ◽

Vol 6 (1_suppl) ◽

pp. s-0036-1582941-s-0036-1582941 ◽

Cited By ~ 1

Author(s):

Aidin Abedi ◽

Simin Seyedpour ◽

Lidwine B. Mokkink ◽

Farhad Shokraneh ◽

Vafa Rahimi-Movaghar

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measures ◽

Patient Reported Outcome Measures ◽

Patient Reported Outcome ◽

Measurement Properties ◽

Cord Injury ◽

Patient Reported

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Electrophysiological Outcome Measures in Spinal Cord Injury Clinical Trials: A Systematic Review

Topics in Spinal Cord Injury Rehabilitation ◽

10.1310/sci2504-340 ◽

2019 ◽

Vol 25 (4) ◽

pp. 340-354

Author(s):

Radha Korupolu ◽

Argyrios Stampas ◽

Mani Singh ◽

Ping Zhou ◽

Gerard Francisco

Keyword(s):

Systematic Review ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Clinical Trials ◽

Evoked Potentials ◽

Outcome Measures ◽

Outcome Measure ◽

Silent Period ◽

Contact Heat Evoked Potentials ◽

Cord Injury

Background: Electrophysiological measures are being increasingly utilized due to their ability to provide objective measurements with minimal bias and to detect subtle changes with quantitative data on neural function. Heterogeneous reporting of trial outcomes limits effective interstudy comparison and optimization of treatment. Objective: The objective of this systematic review is to describe the reporting of electrophysiological outcome measures in spinal cord injury (SCI) clinical trials in order to inform a subsequent consensus study. Methods: A systematic search of PubMed and EMBASE databases was conducted according to PRISMA guidelines. Adult human SCI clinical trials published in English between January 1, 2008 and September 15, 2018 with at least one electrophysiological outcome measure were eligible. Findings were reviewed by all authors to create a synthesis narrative describing each outcome measure. Results: Sixty-four SCI clinical trials were included in this review. Identified electrophysiological outcomes included electromyography activity (44%), motor evoked potentials (33%), somatosensory evoked potentials (33%), H-reflex (20%), reflex electromyography activity (11%), nerve conduction studies (9%), silent period (3%), contact heat evoked potentials (2%), and sympathetic skin response (2%). Heterogeneity was present in regard to both methods of measurement and reporting of electrophysiological outcome measures. Conclusion: This review demonstrates need for the development of a standardized reporting set for electrophysiological outcome measures. Limitations of this review include exclusion of non-English publications, studies more than 10 years old, and an inability to assess methodological quality of primary studies due to a lack of guidelines on reporting of systematic reviews of outcome measures.

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