Inter-rater reliability of the modified Medical Research Council scale in patients with chronic incomplete spinal cord injury

2019 ◽  
Vol 30 (4) ◽  
pp. 515-519 ◽  
Author(s):  
Esther B. Dupépé ◽  
Matthew Davis ◽  
Galal A. Elsayed ◽  
Bonita Agee ◽  
Keneshia Kirksey ◽  
...  

OBJECTIVEThe aim of this study was to determine the inter-rater reliability of the modified Medical Research Council (MRC) scale for grading motor function in patients with chronic incomplete spinal cord injury (SCI).METHODSTwo neurosurgical residents and 2 faculty members performed motor examinations in 6 chronic incomplete SCI patients for a total of 156 muscle groups. Examinations were performed using the modified MRC grading scale during routine clinic visits for each patient. Informed consent was obtained prior to enrollment. Patients with American Spinal Injury Association (ASIA) Impairment Scale grade A (ASIA A) injuries were excluded. Inter-rater reliability coefficients were calculated using Kendall’s coefficient of concordance (W) and intraclass correlation coefficients (ICCs).RESULTSSixty-four percent of the tested variables demonstrated extremely strong (W 0.71–0.9) or strong (0.51–0.7) inter-rater reliability using Kendall’s coefficient of concordance and an ICC corresponding to excellent (ICC > 0.75) or fair to good (ICC 0.4–0.75) inter-rater reliability. An additional 7% showed poor inter-rater reliability (ICC < 0.4). The remaining variables tested did not reach statistical significance.CONCLUSIONSThe inter-rater reliability of the modified MRC scale was found to be high in the majority of tested variables, but the results suggest that discrepancy among trained observers does exist. Reliability was greatest in the lower-extremity muscle groups and least in the upper-extremity muscle groups in patients with chronic incomplete SCI.

Author(s):  
Akbar Hojjati Najafabadi ◽  
Saeid Amini ◽  
Farzam Farahmand

The majority of the people with incomplete spinal cord injury lose their walking ability, due to the weakness of their muscle motors in providing torque. As a result, developing assistive devices to improve their conditionis of great importance. In this study, a combined application of the saddle-assistive device (S-AD) and mechanical medial linkage or thosis was evaluated to improve the walking ability in patients with spinal cord injury in the gait laboratory. This mobile assistive device is called the saddle-assistive device equipped with medial linkage or thosis (S-ADEM). In this device, a mechanical orthosis was used in a wheeled walker as previously done in the literature. Initially, for evaluation of the proposed assistive device, the experimental results related to the forces and torques exerted on the feet and upper limbs of a person with the incomplete Spinal Cord Injury (SCI) during walking usingthe standard walker were compared with an those obtained from using the S-ADEM on an able-bodied subject. It was found that using this combination of assistive devices decreases the vertical force and torque on the foot at the time of walking by 53% and 48%, respectively compared to a standard walker. Moreover, the hand-reaction force on the upper limb was negligible instanding and walking positions usingthe introduced device. The findings of this study revealed that the walking ability of the patients with incomplete SCI was improved using the proposed device, which is due to the bodyweight support and the motion technology used in it.


Spinal Cord ◽  
2013 ◽  
Vol 52 (3) ◽  
pp. 216-219 ◽  
Author(s):  
W Saensook ◽  
S Phonthee ◽  
K Srisim ◽  
L Mato ◽  
P Wattanapan ◽  
...  

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