Quantitative testing in spinal cord injury: overview of reliability and predictive validity

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Clinical Measurement

Background:

• Monitoring individuals with spinal cord injury (SCI) necessitates reliable and valid outcome measures.
• Quantitative physiological measures offer objective insights into sensory and motor function.
• Assessing the utility of these measures is crucial for effective SCI management and research.

Purpose of the Study:

• To identify commonly used quantitative physiological outcome measures in SCI.
• To systematically review the evidence on the reliability and predictive validity of these measures.
• To evaluate the quality of existing studies on SCI outcome measure assessment.

Main Methods:

• Systematic literature search of PubMed up to January 2012.
• Inclusion of studies evaluating reliability (using ICC or weighted κ) and predictive validity (correlation with functional outcomes).
• Definition of quantitative measures as tests quantifying sensory/motor function or evoked potentials.

Main Results:

• Six reliability and four predictive validity studies met inclusion criteria.
• Electrical perceptual threshold (EPT) showed good reliability above the SCI level; GRASSP components demonstrated high reliability (ICC 0.84-0.98).
• Overall study quality was poor due to small sample sizes and potential bias; evidence for predictive validity was limited, with some correlation noted for SSEPs and ambulatory capacity but not bladder function.

Conclusions:

• Evidence for the reliability and validity of quantitative SCI measures is limited, with poor overall study quality.
• EPT, dermatomal SSEPs, and GRASSP show some promise for longitudinal SCI studies.
• High-quality research is needed to establish the reliability, responsiveness, and validity of quantitative measures for SCI monitoring.