Topics in spinal cord injury rehabilitation · 2025
An Evaluation of International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Performance Within the Canadian SCI Network.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Hong Heather A, Parsons Jessica, Xu Jijie, Walden Kristen, Fallah Nader, Cheng Christiana L, Attabib Najmedden, Christie Sean D, Craven B Catharine, Fehlings Michael G, Fourney Daryl R, Ho Chester, Julien Lisa, Kwon Brian K, Linassi Gary A, Loyola-Sanchez Adalberto, Moganathas Saranjan, Paquet Jerome, Sreenivasan Vidya, Mac-Thiong Jean-Marc, Townson Andrea, Tsai Eve C, Urquhart Jennifer, Whelan Alexander, Noonan Vanessa K, ISNCSCI Working Group
Аннотация
OBJECTIVES: To describe the performance of the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination in individuals with traumatic spinal cord injury (TSCI) and nontraumatic spinal cord injury (NTSCI) across Canadian acute and rehabilitation facilities, evaluating timing, completeness, and classification accuracy.
METHODS: Using the Rick Hansen Spinal Cord Injury Registry (2015-2022), participants were analyzed across 6 cohorts: (A) TSCI-acute-admission (n = 4461), (B) TSCI-acute-discharge (n = 972), (C) TSCI-rehabilitation-admission (n = 2673), (D) TSCI-rehabilitation-discharge (n = 2316), (E) NTSCI-rehabilitation-admission (n = 728), and (F) NTSCI-rehabilitation-discharge (n = 619). ISNCSCI data included performed (yes/no), timing (≤72 hours, ≤7 days, and >7 days of admission/discharge), completeness, missing items, and worksheet used (yes/no). Classification accuracy between the clinician-determined and algorithm-generated ASIA Impairment Scale and neurological level of injury classification was evaluated. Descriptive and bivariate statistics were used to analyze cohorts.
RESULTS: Overall, 70% of participants had at least one examination performed, with 76% performed ≤72 hours, 91% ≤7 days, and 9% >7 days. However, 45% were partially complete, primarily missing sensory scores and rectal components ≤7 days. Comparison of TSCI and NTSCI during rehabilitation showed that NTSCI cohorts had significantly more exams at admission and fewer at discharge, with more complete exams. Moreover, age at injury, injury type, mechanism, severity, length of stay, and pain influenced examination performance.
CONCLUSION: This study highlights the need for greater consistency in ISNCSCI examination performance and identifies patient-level barriers to completion. Determining the most effective standardized approach for ISNCSCI use across SCI care, addressing modifiable human/organizational factors, and ensuring comprehensive clinical training will improve the quality of this assessment.
METHODS: Using the Rick Hansen Spinal Cord Injury Registry (2015-2022), participants were analyzed across 6 cohorts: (A) TSCI-acute-admission (n = 4461), (B) TSCI-acute-discharge (n = 972), (C) TSCI-rehabilitation-admission (n = 2673), (D) TSCI-rehabilitation-discharge (n = 2316), (E) NTSCI-rehabilitation-admission (n = 728), and (F) NTSCI-rehabilitation-discharge (n = 619). ISNCSCI data included performed (yes/no), timing (≤72 hours, ≤7 days, and >7 days of admission/discharge), completeness, missing items, and worksheet used (yes/no). Classification accuracy between the clinician-determined and algorithm-generated ASIA Impairment Scale and neurological level of injury classification was evaluated. Descriptive and bivariate statistics were used to analyze cohorts.
RESULTS: Overall, 70% of participants had at least one examination performed, with 76% performed ≤72 hours, 91% ≤7 days, and 9% >7 days. However, 45% were partially complete, primarily missing sensory scores and rectal components ≤7 days. Comparison of TSCI and NTSCI during rehabilitation showed that NTSCI cohorts had significantly more exams at admission and fewer at discharge, with more complete exams. Moreover, age at injury, injury type, mechanism, severity, length of stay, and pain influenced examination performance.
CONCLUSION: This study highlights the need for greater consistency in ISNCSCI examination performance and identifies patient-level barriers to completion. Determining the most effective standardized approach for ISNCSCI use across SCI care, addressing modifiable human/organizational factors, and ensuring comprehensive clinical training will improve the quality of this assessment.