Validation of the Thai version of the Spinal Cord Independence Measure Self-Report (SCIM-SR-Thai).

STUDY DESIGN: Cross-sectional validation study OBJECTIVES: To cross-culturally translate and evaluate the psychometric properties of the Thai version of the Spinal Cord Independence Measure Self-Report (SCIM-SR-Thai) in Thai people with spinal cord injury (SCI) SETTING: Rehabilitation Ward at Maharaj Nakorn Chiang Mai Hospital METHODS: A cross-cultural forward and backward translation of the English version SCIM-SR into Thai was performed following the standard guideline. Sixty-one participants completed the SCIM-SR-Thai. On the same day, the rehabilitation medicine resident administered the Spinal Cord Independence Measure III (SCIM III) by observation. The Cronbach's alpha, Pearson's correlation coefficients and intraclass correlation coefficients (ICC) were used to assess internal consistency and concurrent validity, respectively. The Bland-Altman analysis and regression analysis evaluated the differences in scores between instruments. To explore the construct validity, confirmatory factor analysis (CFA) was conducted. RESULTS: The SCIM-SR-Thai provided excellent internal consistency (Cronbach's alpha ≥ 0.96). The Pearson's correlation coefficients and ICC revealed strong correlation with values of 0.93, 0.94, 0.95, and 0.97 in respiration and sphincter management, self-care, mobility, and total score, respectively. The regression analysis demonstrated that onset of injury of less than one year might be a possible predictor of the difference between the scores. CFA showed that the three-factor-model had an acceptable fit to the data but the unidimensional model fit the data better. CONCLUSIONS: The SCIM-SR-Thai had excellent internal consistency and good validity for evaluating functional independence in Thai people with SCI. Persons with recent onset of injury might have limited ability for self-assessment of their functions.

Intermittent tetraburst stimulation combined with transcranial direct current stimulation once weekly for treatment-resistant depression: a case report.

BACKGROUND: Single-time non-invasive brain stimulation was carried out using the two-technique approach on a patient suffering from treatment-resistant depression. Five treatment sessions given at weekly intervals resulted in a significant improvement in the Patient Health Questionnaire-9 score for up to 6 weeks. The findings of this study could pave the way for a more efficient less resource-intensive time- and budget-saving technique of employing non-invasive brain stimulation for patients with treatment-resistant depression by minimizing the number of stimulation sessions. CASE PRESENTATION: A 67-year-old married non-Latino white American woman suffering from treatment-resistant depression received intermittent tetraburst stimulation in combination with transcranial direct current stimulation weekly for 5 consecutive weeks. Diagnostic transcranial magnetic stimulation showed an observable electrophysiological change. The patient reported a drastic improvement in Patient Health Questionnaire-9 score up until 6-week follow-up and expressed satisfaction with the treatment. CONCLUSIONS: This case study suggests that a streamlined protocol for using non-invasive brain stimulation could prove more effective for patients and healthcare providers in terms of safety in comparison to the present guidelines.