Rita Hamilton1,2, Steven Kirshblum3,4, Seema Sikka1,2, Librada Callender1,2, Monica Bennett1,5, Purvi Prajapati5. 1. a Baylor Institute for Rehabilitation , Dallas , Texas , USA. 2. b Baylor University Medical Center , Dallas , Texas , USA. 3. c Kessler Institute for Rehabilitation , West Orange , New Jersey , USA. 4. d Rutgers New Jersey Medical School , Newark , New Jersey , USA. 5. e Center for Clinical Effectiveness, Baylor Scott and White Health , Dallas , Texas , USA.
Abstract
OBJECTIVE: To determine if a self-report measure of S4-5 motor and sensory function in patients with chronic SCI accurately predicts sacral examination results. DESIGN: Prospective, single-blinded self-report survey compared with sacral exam. SETTING: Outpatient SCI clinic. PARTICIPANTS: 116 patients aged 18+ with chronic SCI > 6 months who have undergone sacral exam. INTERVENTIONS: The survey included demographic/clinical and sacral function information such as light tough (LT), pinprick sensation (PP), deep anal pressure (DAP) and voluntary anal contraction (VAC). Survey results and sacral exam were compared and stratified by the patient's American Spinal Cord Injury Association Impairment Scale (AIS) category. OUTCOME MEASURES: Sacral self-report survey, AIS examination. RESULTS: Mean age was 41.3 ± 14.4 years with majority male (69%) and Caucasian (71.6%). Overall, Positive Predictive Value (PPV) ranged between 48% (VAC) to 73% (DAP) and Negative Predictive Value (NPV) between 92% (VAC) to 100% (LT). AIS-A had NPV of 100% across all categories, and AIS-D had PPV of 100% across all categories. CONCLUSION: Patient report of sacral sparing can predict negative sensation in patients with AIS-A and predict positive sensation in persons with AIS-D. Overall, the self-report of sacral sparing of motor and sensory function is not predictive enough to rely on for accurate classification.
OBJECTIVE: To determine if a self-report measure of S4-5 motor and sensory function in patients with chronic SCI accurately predicts sacral examination results. DESIGN: Prospective, single-blinded self-report survey compared with sacral exam. SETTING:Outpatient SCI clinic. PARTICIPANTS: 116 patients aged 18+ with chronic SCI > 6 months who have undergone sacral exam. INTERVENTIONS: The survey included demographic/clinical and sacral function information such as light tough (LT), pinprick sensation (PP), deep anal pressure (DAP) and voluntary anal contraction (VAC). Survey results and sacral exam were compared and stratified by the patient's American Spinal Cord Injury Association Impairment Scale (AIS) category. OUTCOME MEASURES: Sacral self-report survey, AIS examination. RESULTS: Mean age was 41.3 ± 14.4 years with majority male (69%) and Caucasian (71.6%). Overall, Positive Predictive Value (PPV) ranged between 48% (VAC) to 73% (DAP) and Negative Predictive Value (NPV) between 92% (VAC) to 100% (LT). AIS-A had NPV of 100% across all categories, and AIS-D had PPV of 100% across all categories. CONCLUSION:Patient report of sacral sparing can predict negative sensation in patients with AIS-A and predict positive sensation in persons with AIS-D. Overall, the self-report of sacral sparing of motor and sensory function is not predictive enough to rely on for accurate classification.
Authors: Ralph J Marino; Mary Schmidt-Read; Steven C Kirshblum; Trevor A Dyson-Hudson; Keith Tansey; Leslie R Morse; Daniel E Graves Journal: Arch Phys Med Rehabil Date: 2016-02-26 Impact factor: 3.966
Authors: Steven Kirshblum; Amanda Botticello; Daniel P Lammertse; Ralph J Marino; Anthony E Chiodo; Amitabh Jha Journal: Arch Phys Med Rehabil Date: 2011-03 Impact factor: 3.966