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Construct validity and dimensional structure of the ASIA motor scale
Daniel E Graves1, Ronald G Frankiewicz, William H Donovan
1Baylor College of Medicine, 1333 Moursund, A-222, Houston, TX 77030, USA. dgraves@bcm.tmc.edu
The Journal of Spinal Cord Medicine
|April 1, 2006
Summary
Separate upper and lower extremity scales provide a more accurate measure of motor function after spinal cord injury than a single combined score. This improves measurement accuracy in research outcomes.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biostatistics
Background:
- The American Spinal Injury Association (ASIA) motor score is widely used to assess motor function.
- Its metrological properties as an outcome measure require thorough investigation.
Purpose of the Study:
- To test if separate upper and lower extremity scales offer a more accurate motor function assessment than a single combined ASIA motor score.
- To evaluate the underlying dimensionality of the ASIA motor scale.
Main Methods:
- Analysis of archived data from 6116 ASIA motor scale records.
- Statistical comparison of motor function representation using single versus separate extremity scales.
Main Results:
- Separate scales significantly improved motor function representation (chi2=2596, P < 0.0001).
- Two scales explained 87% of variance, compared to 82% for a single scale.
- Upper extremity function was accurately represented only by separate scales.
Conclusions:
- Strong evidence supports two distinct dimensions within the ASIA motor scale.
- Using separate upper and lower extremity scales reduces measurement error in spinal cord injury research.
- The utility of a single ASIA motor score as an outcome measure should be critically evaluated.
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