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首页> 外文期刊>Neurorehabilitation and neural repair >Prediction and Stratification of Upper Limb Function and Self-Care in Acute Cervical Spinal Cord Injury With the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP)
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Prediction and Stratification of Upper Limb Function and Self-Care in Acute Cervical Spinal Cord Injury With the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP)

机译：用强度，敏感度和感觉（​​GRASSP）分级重新定义评估急性颈脊髓损伤中上肢功能和自我护理的预测和分层

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Background. There is inherent heterogeneity within individuals suffering from cervical spinal cord injury (SCI), and early prediction of upper limb function and self-care is challenging. As a result, considerable uncertainty exists regarding the prediction of functional outcome following cervical SCI within 1 year of injury. Objective. To evaluate the value of Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) in predicting upper limb function and self-care outcomes in individuals with cervical SCI. Method. A prospective longitudinal multicenter study was performed. Data from the GRASSP, the Spinal Cord Independence Measure (SCIM III), and the American Spinal Injury Association (ASIA) Impairment Scale were recorded at 1,6, and 12 months after cervical SCI. For prediction of functional outcome at 6 and 12 months, a logistic regression model, receiver operating characteristics (ROC), and unbiased recursive partitioning conditional inference tree (URP-CTREE) were used with 8 different predictor variables. Results. Logistic regression analysis, ROC analysis, and URP-CTREE all revealed that the strength subtest within GRASSP is the strongest predictor for upper limb function and self-care outcomes. URP-CTREE provides useful information on the distribution of different outcomes in acute cervical SCI and can be used to predict cohorts with homogeneous outcomes. Conclusion. The GRASSP at I month can accurately predict upper limb function and self-care outcomes even in a heterogeneous group of individuals across a wide spectrum of neurological recovery. The application of URP-CTREE can reveal the distribution of outcome categories and, based on this, inform trial protocols with respect to outcomes analysis and patient stratification.
机译：背景。在患有颈脊髓损伤（SCI）的个体中存在固有的异质性，并且对上肢功能和自我护理的早期预测具有挑战性。结果，对于在损伤后1年内宫颈SCI的功能预后的预测存在相当大的不确定性。目的。若要评估强度，敏感性和理解力的分级重新定义评估（GRASSP）在预测宫颈SCI患者的上肢功能和自我护理结局中的价值。方法。进行了一项前瞻性纵向多中心研究。在颈椎脊髓损伤后1,6和12个月记录了来自GRASSP，脊髓独立性评估（SCIM III）和美国脊髓损伤协会（ASIA）损害量表的数据。为了预测6个月和12个月的功能结局，使用了Logistic回归模型，接收者操作特征（ROC）和无偏递归分区条件推断树（URP-CTREE），并带有8个不同的预测变量。结果。 Logistic回归分析，ROC分析和URP-CTREE均显示，GRASSP中的强度子测试是上肢功能和自我护理结局的最强预测指标。 URP-CTREE可提供有关急性宫颈SCI中不同结局分布的有用信息，并可用于预测均一结局的队列。结论。在一个月的GRASSP上，即使在广泛的神经功能恢复的异类人群中，也可以准确预测上肢功能和自我护理结局。 URP-CTREE的应用可以揭示结果类别的分布，并在此基础上为有关结果分析和患者分层的试验方案提供信息。

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