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An interview based approach to the anorectal portion of the International Standards of Neurological Classification of Spinal Cord Injury Exam (I-A-ISNCSCI): a pilot study.
Spinal Cord ( IF 2.1 ) Pub Date : 2019-12-10 , DOI: 10.1038/s41393-019-0399-5
Audrey Chun 1 , Andrew D Delgado 1, 2 , Chung-Ying Tsai 1 , Lisa Spielman 1 , Kristell Taylor 1, 2 , Arianny Ramirez 1 , Vincent Huang 1 , Stephanie A Kolakowsky-Hayner 1 , Miguel X Escalon 1 , Thomas N Bryce 1
Affiliation  

STUDY DESIGN Prospective, single-blinded study. OBJECTIVE To design and evaluate the use of an interview based version of the anorectal portion of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam in the acute inpatient rehabilitation (AIR) setting. SETTING AIR unit. METHODS Participants admitted to AIR underwent standard ISNCSCI exams (S-ISNCSCI) as part of routine inpatient care within 3 days of being administered an interview version of the anorectal portion of the ISNCSCI (I-A-ISNCSCI). Agreement between the anorectal portion of the S-ISNCSCI (S-A-ISNCSCI) and the I-A-ISNCSCI was evaluated. RESULTS Forty of forty-five enrolled participants completed the assessments. Agreement between the I-A-ISNCSCI and S-A-ISNCSCI was substantial for anorectal sensation to light touch (k = 0.71, 95% CI 0.52-0.90, N = 36), pin prick (k = 0.68, 95% CI 0.48-0.87, N = 38), deep anal pressure (k = 0.77, 95% CI 0.53-1.00, N = 37), and completeness of injury based on combined sacral sensory criteria (k = 0.72, 95% CI 0.47-0.97, N = 40); and fair for voluntary anal contraction (k = 0.29, 95% CI -0.01 to 0.59, N = 36). Responses of "I don't know" were excluded from agreement analyses. CONCLUSIONS This pilot study was a first step in developing interview based tools such as the I-A-ISNCSCI in an AIR setting providing convenient access to individuals with SCI and their direct feedback. The study design introduces potential recall bias and may not match true clinical situations such as remote follow-up of neurological changes for chronic patients. The use of interview based tools for assessing individuals with SCI remains worthy of further study.

中文翻译:

基于访谈的国际脊髓损伤神经分类学神经标准分类考试(IA-ISNCSCI)的肛门直肠部分方法:一项试点研究。

研究设计前瞻性单盲研究。目的设计和评估在急性住院患者康复(AIR)环境中使用基于访谈的《国际脊髓损伤神经分类学标准》(ISNCSCI)肛肠部分的版本。设置空气单元。方法接受AIR的参与者在接受ISNCSCI肛门直肠部分的访谈版本(IA-ISNCSCI)的3天内接受了常规ISNCSCI考试(S-ISNCSCI),作为常规住院治疗的一部分。评估了S-ISNCSCI的肛门直肠部分(SA-ISNCSCI)与IA-ISNCSCI之间的一致性。结果四十五名登记的参与者完成了评估。IA-ISNCSCI和SA-ISNCSCI之间的协议对于肛肠对轻触的感觉至关重要(k = 0.71,95%CI 0.52-0。90,N = 36),针刺(k = 0.68,95%CI 0.48-0.87,N = 38),深肛门压力(k = 0.77,95%CI 0.53-1.00,N = 37),损伤的完整性基于combined骨感觉综合标准(k = 0.72,95%CI 0.47-0.97,N = 40); 并且对自愿性肛门收缩比较公平(k = 0.29,95%CI -0.01至0.59,N = 36)。协议分析中排除了“我不知道”的答复。结论这项初步研究是在基于AIR的环境中开发基于面试的工具(例如IA-ISNCSCI)的第一步,该工具为具有SCI及其直接反馈的个人提供了便捷的访问渠道。该研究设计引入了潜在的回忆偏倚,可能与真实的临床情况不符,例如对慢性患者的神经系统变化进行远程随访。使用基于面试的工具评估SCI个体仍然值得进一步研究。N = 36),针刺(k = 0.68,95%CI 0.48-0.87,N = 38),深肛门压力(k = 0.77,95%CI 0.53-1.00,N = 37),以及基于损伤的完整性骨综合感觉标准(k = 0.72,95%CI 0.47-0.97,N = 40); 并且对自愿性肛门收缩比较公平(k = 0.29,95%CI -0.01至0.59,N = 36)。协议分析中排除了“我不知道”的答复。结论这项初步研究是在基于AIR的环境中开发基于面试的工具(例如IA-ISNCSCI)的第一步,该工具为具有SCI及其直接反馈的个人提供了便捷的访问渠道。该研究设计引入了潜在的回忆偏倚,可能与真实的临床情况不符,例如对慢性患者的神经系统变化进行远程随访。使用基于面试的工具评估SCI个体仍然值得进一步研究。N = 36),针刺(k = 0.68,95%CI 0.48-0.87,N = 38),深肛门压力(k = 0.77,95%CI 0.53-1.00,N = 37),以及基于损伤的完整性骨综合感觉标准(k = 0.72,95%CI 0.47-0.97,N = 40); 并且对自愿性肛门收缩比较公平(k = 0.29,95%CI -0.01至0.59,N = 36)。协议分析中排除了“我不知道”的答复。结论这项初步研究是在基于AIR的环境中开发基于面试的工具(例如IA-ISNCSCI)的第一步,该工具为具有SCI及其直接反馈的个人提供了便捷的访问渠道。该研究设计引入了潜在的回忆偏倚,可能与真实的临床情况不符,例如对慢性患者的神经系统变化进行远程随访。使用基于面试的工具评估SCI个体仍然值得进一步研究。
更新日期:2019-12-11
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