A New Measure of Neurological and Behavioral Recovery after SCI
Craig Neilson Foundation
September 2010 – August 2012
The long-term purpose of this proposal is to establish the reliability, validity and responsiveness of the phase system for measurement of functional disability after SCI and recovery from that disability. A paucity of clinical trials for SCI stems in part from the lack of valid, reliable and sensitive outcome measures for people with different severities of SCI. An ideal outcome measure would reliably classify the severity of SCI based on functional ability and most importantly detect meaningful changes in recovery of pre-morbid function over time. Current measures do not distinguish between recovery of function and achievement of a functional ability. The specific purpose of this request is to conduct a review and analyses on the validity of the current (Feb 2008 to present) Phase assessment data for the NRN adult population with motor incomplete SCI. This project is funded by the Neilsen Foundation and targets the development of the Phase Scale as a new measure of neurological and behavioral recovery after SCI. Two hypotheses relevant to the current request are: Hypothesis 1A: The phase system is multidimensional (e.g. reflects different constructs of movement like trunk extension in sitting, standing).
Hypothesis 1B: The items representing each identified dimension fit a 1-parameter Item Response Theory model; show a clinically-relevant item difficulty hierarchy, and reliably separate patients into significant strata based on movement ability. We will apply Rasch Analysis and Factor Analysis using NRN-generated phase data to finalize phase system items and hierarchy.
Spinal Cord Injury; Rasch Analysis; Functional Ability