[Validation of a New Sensorimotor Assessment for Neurological-Neurosurgical Early Rehabilitation]

The treatment of sensorimotor disorders is a central component of neurological and neurosurgical early rehabilitation (NNER). To date, a comprehensive sensorimotor assessment for severely affected patients is not available. Therefore, the Sensorimotor Assessment Physiotherapie (SeMo-P) was developed at the Lurija Institut (Kliniken Schmieder in Germany). It comprises four independent components assessing different aspects of sensorimotor function: SeMo_Sensibility (sensitivity of the legs), SeMo_PM (passive joint mobility of the legs), SeMo_AM (active joint mobility of the legs), and SeMo_Mobility (patient mobility). The aim of this study was the systematic evaluation of the quality criteria reliability, validity, and responsiveness.

The sample consisted of 50 patients who completed the SeMo-P shortly after admission to the NNER (t1) and again four weeks later (t2). Appropriate psychometric methods were used to test reliability (internal consistency, inter-rater reliability), validity (convergent validity and concurrent/predictive criterion validity), responsiveness and the occurrence of floor or ceiling effects for each part.

All parts of the SeMo-P showed overall good internal consistency (Cronbach's α: 0.72 - 0.97). In terms of inter-rater reliability, SeMo_Sensitivity, SeMo_AM, and SeMo_Mobility achieved excellent values (ICC_2,1: 0.98 - 0.99, p<0.001), while SeMo_PM fell within the moderate range (ICC_2,1: 0.71, p<0.001). Validity was only examined for the SeMo_Mobility, which had good construct (r_s: 0.91 - 0.95, p<0.001) and criterion validity (r_s: 0.68 - 0.73, p<0.001). All parts of the assessment record change over time (responsiveness), whereby the SeMo_Sensitivity could detect changes in fewer patients, which was presumably due to a ceiling effect at t1. The SeMo_PM also showed a ceiling effect. The SeMo_Mobility and the SeMo_AM showed very good results in terms of responsiveness and there were neither floor nor ceiling effects.

The study shows that the quality criteria of the SeMo-P items range from moderate to excellent. For clinical practice, the use of SeMo_AB and SeMo_Mobility is recommended. It should be noted that no investigation of validity has yet been conducted for the SeMo_AB. The other parts can be used optionally depending on the specific question.