Responsiveness, Sensitivity, and Minimally Detectable Difference of the Graded and Redefined Assessment of Strength, Sensibility, and Prehension, Version 1.0
Responsiveness, Sensitivity, and Minimally Detectable Difference of the Graded and Redefined Assessment of Strength, Sensibility, and Prehension, Version 1.0
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DOI：
10.1089/neu.2015.4217
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发表时间：
2016-02-01
影响因子：
4.2
通讯作者：
Fehlings, Michael G.
中科院分区：
文献类型：
--
作者：
Kalsi-Ryan, Sukhvinder;Beaton, Dorcas;Fehlings, Michael G.
随着脊髓损伤（SCI）试验开始涉及急性颈脊髓损伤受试者，建立上肢结局指标的属性以检测随时间的变化对于其在临床试验中的有用性至关重要。本研究的目的是定义强度、敏感性和感知的分级重新定义评估（GRASSP）的反应性、敏感性和最小可检测差异（MDD）。进行了一项观察性纵向研究。分别于伤后0-10天、1、3、6、12个月进行脊髓损伤国际神经分类标准（ISNCSCI）、GRASSP、上肢功能问卷（CUE-Q）和脊髓独立性测量（SCIM）。计算GRASSP和ISNCSCI测量的标准化响应均值（SRM）。纵向结构效度采用Pearson相关系数进行计算。计算所有子测试的最小真实的差异，以定义所有GRASSP子测试的MDD值。纵向结构效度证明GRASSP和所有外部措施对损伤后1年的神经变化有反应。GRASSP子测试的SRM值比ISNCSCI强度和感觉、SCIM-SS和CUE-Q的SRM值大0.25至0.85个单位。GRASSP子测试的MDD值范围为2-5分。GRASSP表现出良好的响应性和卓越的灵敏度，上级ISNCSCI和SCIM III。MDD值在临床和研究环境中的干预措施评价中是有用的。GRASSP的反应性和敏感性使其成为四肢瘫痪患者的一种有价值的条件特异性措施，其中上肢神经和功能结局的变化对于评估干预措施的有效性至关重要。
As spinal cord injury (SCI) trials begin to involve subjects with acute cervical SCI, establishing the property of an upper limb outcome measure to detect change over time is critical for its usefulness in clinical trials. The objectives of this study were to define responsiveness, sensitivity, and minimally detectable difference (MDD) of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP). An observational, longitudinal study was conducted. International Standards of Neurological Classification of SCI (ISNCSCI), GRASSP, Capabilities of Upper Extremity Questionnaire (CUE-Q), and Spinal Cord Independence Measure (SCIM) were administered 0-10 days, 1, 3, 6, and 12 months post-injury. Standardized Response Means (SRM) for GRASSP and ISNCSCI measures were calculated. Longitudinal construct validity was calculated using Pearson correlation coefficients. Smallest real difference for all subtests was calculated to define the MDD values for all GRASSP subtests. Longitudinal construct validity demonstrated GRASSP and all external measures to be responsive to neurological change for 1 year post-injury. SRM values for the GRASSP subtests ranged from 0.25 to 0.85 units greater than that for ISNCSCI strength and sensation, SCIM-SS, and CUE-Q. MDD values for GRASSP subtests ranged from 2-5 points. GRASSP demonstrates good responsiveness and excellent sensitivity that is superior to ISNCSCI and SCIM III. MDD values are useful in the evaluation of interventions in both clinical and research settings. The responsiveness and sensitivity of GRASSP make it a valuable condition-specific measure in tetraplegia, where changes in upper limb neurological and functional outcomes are essential for evaluating the efficacy of interventions.