Validity and reliability study of the Turkish version of Spinal Cord Independence Measure-III.

STUDY DESIGN: This is a multicenter, prospective study. OBJECTIVES: The objective of this study was to assess the validity and reliability of the Turkish version of Spinal Cord Independence Measure-III (SCIM-III). SETTING: This study was conducted in rehabilitation centers of three hospitals in Turkey. METHODS: Two-hundred and four (n=204) consecutive patients with spinal cord injury (SCI) were included in the study. Each patient was examined by two physicians. Neurologic impairment was measured according to the American Spinal Injury Association (ASIA) Impairment Scale (AIS) 2000 revised criteria. Backward and forward translation of SCIM-III was performed by native speakers in both languages. To measure the validity of SCIM-III, the scores were compared with patients' AIS grades, total motor scores and the Health Survey Short Form-36 (SF-36) subscale scores. SCIM-III was analyzed for test-retest reliability by the same rater on 49 patients during the follow-up evaluations. RESULTS: Total agreement values between raters changed between 75.9 and 100%. Kappa values were all above 0.6, and they were statistically significant. The Pearson's correlation values between the raters were very high and statistically significant. The Cronbach's α-values for the two consecutive raters were 0.865 and 0.896. Test-retest reliability was assessed by paired samples t-test, and no significant difference was observed. SCIM-III and SF-36 physical (r=0.339, P<0.005) and general health scores (r=0.200, P<0.005) showed correlation. All subscales of the SCIM-III, with the exception of self-care, had significant differences in comparison with the AIS grades. SCIM-III total and total motor scores showed correlation (r=0.585, P<0.001). CONCLUSION: The Turkish version of SCIM-III was found to be valid and reliable.

Piriformis syndrome in an incomplete paraplegic patient: a case report.

STUDY DESIGN: Single case report. OBJECTIVES: We present an incomplete paraplegic patient with lower back and hip pain, diagnosed and treated as the piriformis syndrome (PS). SETTING: University hospital, Turkey. CASE: A 62-year-old woman with T3 paraplegia of American Spinal Injury Association Impairment Scale grade D presented with lower back and right hip pain accompanied by pain and numbness radiating to her right leg. After detailed anamnesis and physical examination, she was pre-diagnosed as having PS. The marked relief of pain following the ultrasound-guided piriformis muscle injection of 4 cc of lidocaine 2%+1 cc of betametazone confirmed the diagnosis. CONCLUSION: Although the compressive neuropathies and musculoskeletal injuries of the upper limb leading to neuropathic and musculoskeletal pain in persons with spinal cord injury (SCI) are well described in literature, there is limited information regarding those of lower limbs. To the best of our knowledge, this is the first reported case of PS in a patient with SCI. PS should be kept in mind as a pain generator, especially in active and ambulatory SCI patients.