BACKGROUND: For therapeutics directed to the injured spinal cord, a change in neurological impairment has been proposed as a relevant acute clinical study end point. However, changes in neurological function, even if statistically significant, may not be associated with a functional impact, such as a meaningful improvement in items within the self-care subscore of the Spinal Cord Independence Measure (SCIM). OBJECTIVE: The authors examined the functional significance associated with spontaneously recovering upper-extremity motor function after sensorimotor-complete cervical spinal cord injury (SCI). METHODS: Using the European Multi-center Study about Spinal Cord Injury (EMSCI) data set, a retrospective analysis was undertaken of individuals with cervical sensorimotor-complete SCI (initial motor level, C4-C7). Specifically, changes in upper-extremity motor score (UEMS), motor level, and SCIM (total and self-care subscore) were assessed between approximately 1 and 48 weeks after injury (n = 74). RESULTS: The initial motor level did not significantly influence the total UEMS recovered or number of motor levels recovered. SCIM self-care subscore recovery was significantly greater for those individuals regaining 2 motor levels compared with those recovering only 1 or no motor levels. However, the recovery in the SCIM self-care subscore was not significantly different between individuals recovering only 1 motor level and those individuals who showed no motor-level improvement. CONCLUSIONS: A 2 motor-level improvement indicates a clinically meaningful change and might be considered a primary outcome in acute and subacute interventional trials enrolling individuals with cervical sensorimotor-complete SCI.
BACKGROUND: For therapeutics directed to the injured spinal cord, a change in neurological impairment has been proposed as a relevant acute clinical study end point. However, changes in neurological function, even if statistically significant, may not be associated with a functional impact, such as a meaningful improvement in items within the self-care subscore of the Spinal Cord Independence Measure (SCIM). OBJECTIVE: The authors examined the functional significance associated with spontaneously recovering upper-extremity motor function after sensorimotor-complete cervical spinal cord injury (SCI). METHODS: Using the European Multi-center Study about Spinal Cord Injury (EMSCI) data set, a retrospective analysis was undertaken of individuals with cervical sensorimotor-complete SCI (initial motor level, C4-C7). Specifically, changes in upper-extremity motor score (UEMS), motor level, and SCIM (total and self-care subscore) were assessed between approximately 1 and 48 weeks after injury (n = 74). RESULTS: The initial motor level did not significantly influence the total UEMS recovered or number of motor levels recovered. SCIM self-care subscore recovery was significantly greater for those individuals regaining 2 motor levels compared with those recovering only 1 or no motor levels. However, the recovery in the SCIM self-care subscore was not significantly different between individuals recovering only 1 motor level and those individuals who showed no motor-level improvement. CONCLUSIONS: A 2 motor-level improvement indicates a clinically meaningful change and might be considered a primary outcome in acute and subacute interventional trials enrolling individuals with cervical sensorimotor-complete SCI.
Authors: F Biering-Sørensen; S Alai; K Anderson; S Charlifue; Y Chen; M DeVivo; A E Flanders; L Jones; N Kleitman; A Lans; V K Noonan; J Odenkirchen; J Steeves; K Tansey; E Widerström-Noga; L B Jakeman Journal: Spinal Cord Date: 2015-02-10 Impact factor: 2.772
Authors: Michèle Hubli; John L K Kramer; Catherine R Jutzeler; Jan Rosner; Julio C Furlan; Keith E Tansey; Martin Schubert Journal: Spinal Cord Date: 2019-07-23 Impact factor: 2.772
Authors: John D Steeves; Daniel P Lammertse; John L K Kramer; Naomi Kleitman; Sukhvinder Kalsi-Ryan; Linda Jones; Armin Curt; Andrew R Blight; Kim D Anderson Journal: Top Spinal Cord Inj Rehabil Date: 2012-01-31
Authors: Marcel F Dvorak; Vanessa K Noonan; Nader Fallah; Charles G Fisher; Joel Finkelstein; Brian K Kwon; Carly S Rivers; Henry Ahn; Jérôme Paquet; Eve C Tsai; Andrea Townson; Najmedden Attabib; Christopher S Bailey; Sean D Christie; Brian Drew; Daryl R Fourney; Richard Fox; R John Hurlbert; Michael G Johnson; A G Linassi; Stefan Parent; Michael G Fehlings Journal: J Neurotrauma Date: 2014-11-19 Impact factor: 5.269
Authors: Paula Valerie Ter Wengel; Marcel W M Post; Enrico Martin; Janneke Stolwijk-Swuste; Allard Jan Frederik Hosman; Said Sadiqi; William Peter Vandertop; Fetullah Cumhur Öner Journal: Spinal Cord Date: 2020-02-17 Impact factor: 2.772
Authors: C Schuld; S Franz; H J A van Hedel; J Moosburger; D Maier; R Abel; H van de Meent; A Curt; N Weidner; R Rupp Journal: Spinal Cord Date: 2014-12-09 Impact factor: 2.772
Authors: G Scivoletto; J Bonavita; M Torre; I Baroncini; S Tiberti; E Maietti; L Laurenza; S China; V Corallo; F Guerra; L Buscaroli; C Candeloro; E Brunelli; A Catz; M Molinari Journal: Spinal Cord Date: 2015-09-15 Impact factor: 2.772
Authors: Santiago Alvarez-Argote; Heather M Gransee; Juan C Mora; Jessica M Stowe; Amy J Jorgenson; Gary C Sieck; Carlos B Mantilla Journal: J Neurotrauma Date: 2015-11-19 Impact factor: 5.269