A Single Dermatome Clinical Prediction Rule for Independent Walking 1 Year After Spinal Cord Injury.
Arch Phys Med Rehabil
; 105(1): 10-19, 2024 01.
Article
em En
| MEDLINE
| ID: mdl-37414239
ABSTRACT
OBJECTIVE:
To derive and validate a simple, accurate CPR to predict future independent walking ability after SCI at the bedside that does not rely on motor scores and is predictive for those initially classified in the middle of the SCI severity spectrum.DESIGN:
Retrospective cohort study. Binary variables were derived, indicating degrees of sensation to evaluate predictive value of pinprick and light touch variables across dermatomes. The optimal single sensory modality and dermatome was used to derive our CPR, which was validated on an independent dataset.SETTING:
Analysis of SCI Model Systems dataset.PARTICIPANTS:
Individuals with traumatic SCI. The data of 3679 participants (N=3679) were included with 623 participants comprising the derivation dataset and 3056 comprising the validation dataset.INTERVENTIONS:
Not applicable. MAIN OUTCOMEMEASURES:
Self-reported ability to walk both indoors and outdoors.RESULTS:
Pinprick testing at S1 over lateral heels, within 31 days of SCI, accurately identified future independent walkers 1 year after SCI. Normal pinprick in both lateral heels provided good prognosis, any pinprick sensation in either lateral heel provided fair prognosis, and no sensation provided poor prognosis. This CPR performed satisfactorily in the middle SCI severity subgroup.CONCLUSIONS:
In this large multi-site study, we derived and validated a simple, accurate CPR using only pinprick sensory testing at lateral heels that predicts future independent walking after SCI.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Traumatismos da Medula Espinal
/
Regras de Decisão Clínica
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Arch Phys Med Rehabil
Ano de publicação:
2024
Tipo de documento:
Article