German Transcreation of the International Standards to Document Remaining Autonomic Function After Spinal Cord Injury (Second Edition): A Feasibility Study in Individuals With Subacute Phase Spinal Cord Injury/Disease (SCI/D).

BACKGROUND

In May 2021, the second edition of International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) was published.

OBJECTIVES

To transcreate the 2021 ISAFSCI (2nd ed.) to German and to assess its feasibility in the subacute phase following spinal cord injury/disease (SCI/D).

METHODS

Transcreation to German was performed by an interdisciplinary team of native English and German speakers. We screened individuals with SCI/D for eligibility (i.e., age ≥18 years; >3 months following SCI/D) between August 2021 and January 2022. To minimize the time for the assessment, we first interviewed participants in a supine position before conducting the clinical examination. We assessed participants thrice within 14 days using a randomized sequence of assessors, and we assessed SCI/D according to the International Standards for Classification of Spinal Cord Injury (ISNCSCI) grading of the SCI/D, including the American Spinal Injury Association Impairment Scale (AIS). Time of ISAFSCI assessments (median and quartiles) and its completeness (%) were calculated.

RESULTS

Twelve participants (3 females; median age 42 years [Q1: 31, Q3: 54]) were enrolled and assessed thrice. Severity and level of injury were either sensorimotor complete (AIS A, 9) or incomplete (AIS C, 3) SCI/D and tetraplegia (n = 5) or paraplegia (n = 7), respectively. Median time to complete an assessment was 39 minutes (Q1: 32, Q3: 46).

CONCLUSION

The German version of the ISAFSCI second edition is feasible to perform in a subacute cohort. However, given the subacute stage following SCI, certain limitations must be acknowledged. Many participants have not yet engaged in sexual activity, which limits the evaluation of sexual function.