A new grading for easy and concise description of functional status after spinal cord lesions

作者：Bluvshtein V; Front L; Itzkovich M; Benjamini Y; Galili T; Gelernter I; Aidinoff E; Hart J; Tesio L; Biering Sorensen F; Weeks C; Laramee M T; Craven C; Hitzig S L; Glaser E; Zeilig G; Aito S; Scivoletto G; Mecci M; Chadwick R J; El Masry W S; Osman A; Glass C A; Silva P; Soni B M; Gardner B P; Savic G; Bergstroem E M; Catz A^*

来源：Spinal Cord, 2012, 50(1): 42-50.

DOI：10.1038/sc.2011.84

• spinal cord injury
• spinal cord lesion
• SCIM
• classification
• k-medoids algorithm
• multi-center study

Background: Disability scales do not enable the transmission of concise, meaningful and daily function description for clinical purposes. %26lt;br%26gt;Study design: Cross-sectional statistical analysis of 328 patients%26apos; Spinal Cord Independence Measure (SCIM) III item scores (SIS). %26lt;br%26gt;Objective: To develop a concise and clinically interpretable data-based characterization of daily task accomplishment for patients with spinal cord lesions (SCLs). %26lt;br%26gt;Setting: Multi-center study at 13 spinal units in 6 countries. %26lt;br%26gt;Methods: Patients were grouped into clusters characterized by smaller differences between the patients%26apos; SIS within the clusters than between their centers, using the k-medoides algorithm. The number of clusters (k) was chosen according to the percent of SIS variation they explained and the clinical distinction between them. %26lt;br%26gt;Results: Analysis showed that k=8 SIS clusters offer a good description of the patient population. The eight functional clusters were designated as A-H, each cluster (grade) representing a combination of task accomplishments. Higher grades were usually (but not always) associated with patients implementing more difficult tasks. Throughout rehabilitation, the patients%26apos; functional grade improved and the distribution of patients with similar functional grades within the total SCIM III score deciles remained stable. %26lt;br%26gt;Conclusions: A new classification based on SIS clusters enables a concise description of overall functioning and task accomplishment distribution in patients with SCL. A software tool is used to identify the patients%26apos; functional grade. Findings support the stability and utility of the grades for characterizing the patients%26apos; functional status. Spinal Cord (2012) 50, 42-50; doi:10.1038/sc.2011.84; published online 2 August 2011

• 出版日期2012-1