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Titre : | Reliability and Validity of S3 Pressure Sensation as an Alternative to Deep Anal Pressure in Neurologic Classification of Persons With Spinal Cord Injury (2016) |
Auteurs : | Ralph J. Marino ; Mary Schmidt-Read ; Steven C. Kirshblum |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (2016/10, 2016) |
Article en page(s) : | pp. 16421646 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Classification ; Rééducation et réadaptation ; Sensibilité et spécificité ; Traumatismes de la moelle épinière |
Mots-clés: | Reproducibility of results ; Reproductibilité des résultats ; Sensitivity and specificity ; Spinal cord injuries |
Résumé : |
Objective To determine whether pressure sensation at the S3 dermatome (a new test) could be used in place of deep anal pressure (DAP) to determine completeness of injury as part of the International Standards for Neurological Classification of Spinal Cord Injury. Design Prospective, multicenter observational study. Setting U.S. Spinal Cord Injury Model Systems. Participants Persons (N=125) with acute traumatic spinal cord injury (SCI), neurologic levels T12 and above, were serially examined at 1 month (baseline), 3, 6, and 12 months postinjury. There were 80 subjects with tetraplegia and 45 with paraplegia. Interventions S3 pressure sensation at all time points, with a retest at the 1-month time point. Main Outcome Measures Test-retest reliability and agreement (κ), sensitivity, specificity, positive and negative predictive values. Results Test-retest reliability of S3 pressure at 1 month was almost perfect (κ=.98). Agreement of S3 pressure with DAP was substantial both at 1 month (κ=.73) and for all time points combined (κ=.76). The positive predictive value of S3 pressure for DAP was 89.3% at baseline and 90.3% for all time points. No pattern in outcomes was seen in those cases where S3 pressure and DAP differed at 1 month. Conclusions S3 pressure sensation is reliable and has substantial agreement with DAP in persons with SCI at least 1 month postinjury. We suggest S3 pressure as an alternative test of sensory sacral sparing for supraconus SCI, at least in cases where DAP cannot be tested. Further research is needed to determine whether S3 pressure could replace DAP for classification of SCI. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999316001362 |