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Interrater reliability of the Neuromuscular Recovery Scale for spinal cord injury
D Michele Basso1, Craig Velozo2, Doug Lorenz3
1School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH.
Objective:
To determine the interrater reliability of the Neuromuscular Recovery Scale (NRS), an outcome measure designed to classify people with complete or incomplete spinal cord injury (SCI) into 4 phase-of-injury groups by assessing motor performance based on normal preinjury function and disallowing use of compensation for 4 treadmill-based items and 6 overground/mat items.
Design:
Masked comparison, multicenter observational study.
Setting:
Outpatient rehabilitation.
Participants:
Raters (N=14) and a criterion standard expert assigned scores to 10 video NRS assessments of persons with SCI. The raters were volunteers from the NeuroRecovery Network.
Intervention:
Not applicable.
Main Outcome Measure:
Interrater reliability measured with the Kendall coefficient of concordance (W).
Results:
Interrater reliability was generally strong (W=.91-.98; 95% confidence interval [CI], .65-.99), while lower reliability occurred for treadmill stand retraining (W=.87; 95% CI, .06-1) and seated trunk extension (W=.82; 95% CI, .28-.94). Less experienced raters assigned slightly lower scores than the expert for most items, but the difference was less than half a point and did not weaken concordance.
Conclusions:
NRS had strong interrater reliability, a necessary first step in establishing its utility as a clinical and research outcome measure.
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