Article

OBJECTIVE: To determine whether pressure sensation at the S3 dermatome (a new
test) could be used in place of deep anal pressure (DAP) to determine
completeness of injury as part of the International Standards for Neurological
Classification of Spinal Cord Injury. DESIGN: Prospective, multicenter
observational study. SETTING: U.S. Spinal Cord Injury Model Systems.
PARTICIPANTS: Persons (N=125) with acute traumatic spinal cord injury (SCI),
neurologic levels T12 and above, were serially examined at 1 month (baseline), 3,
6, and 12 months postinjury. There were 80 subjects with tetraplegia and 45 with
paraplegia. INTERVENTIONS: S3 pressure sensation at all time points, with a
retest at the 1-month time point. MAIN OUTCOME MEASURES: Test-retest reliability
and agreement (kappa), sensitivity, specificity, positive and negative predictive
values. RESULTS: Test-retest reliability of S3 pressure at 1 month was almost
perfect (kappa=.98). Agreement of S3 pressure with DAP was substantial both at 1
month (kappa=.73) and for all time points combined (kappa=.76). The positive
predictive value of S3 pressure for DAP was 89.3% at baseline and 90.3% for all
time points. No pattern in outcomes was seen in those cases where S3 pressure and
DAP differed at 1 month. CONCLUSIONS: S3 pressure sensation is reliable and has
substantial agreement with DAP in persons with SCI at least 1 month postinjury.
We suggest S3 pressure as an alternative test of sensory sacral sparing for
supraconus SCI, at least in cases where DAP cannot be tested. Further research is
needed to determine whether S3 pressure could replace DAP for classification of SCI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS