Outcome measures: evolution in clinical trials of neurological/functional recovery in spinal cord injury

Spinal Cord
John F Ditunno

Abstract

The need to determine the beneficial effect of the treatment of spinal cord injury (SCI) requires clearly defined standardized measures of the severity of injury and how well the function is restored. Improved neurological recovery should be linked to increased capacity to perform tasks such as walking, reaching and grasping, which results in meaningful gains in mobility and self-care. Measurements of recovery, capacity, mobility and self-care are the outcomes used to determine the benefits from the treatment and have evolved over the last century with contributions by the mentors and protégés of Sir Ludwig Guttmann, whom we honor today. Randomized clinical trials in the past 20 years have taught us many lessons as to which outcome measures have the greatest validity and reliability. The International Standards for Neurological Classification of SCI have become the clinical gold standard for measurement of severity, but would benefit from pathophysiological surrogates to better understand the mechanisms of recovery. Measurements of walking capacity have emerged as valid/reliable/responsive and upper extremity measures are in development, which help distinguish neurological improvement from rehabilitation adaptation. Performance...Continue Reading

References

Jun 27, 1991·The New England Journal of Medicine·M D Walker
Dec 1, 1989·Controlled Clinical Trials·R JaeschkeG H Guyatt
Nov 20, 1998·Archives of Physical Medicine and Rehabilitation·J Whyte
Dec 23, 1998·Archives of Physical Medicine and Rehabilitation·R J MarinoM G Stineman
Jan 24, 2002·Spine·F H GeislerUNKNOWN Sygen Study Group
Oct 9, 2002·Archives of Physical Medicine and Rehabilitation·David A WeitzenkampDaniel P Lammertse
Oct 16, 2004·The Journal of Spinal Cord Medicine·Naomi Kleitman
Nov 3, 2004·Archives of Physical Medicine and Rehabilitation·Ralph J Marino, Daniel E Graves
Feb 12, 2005·Archives of Physical Medicine and Rehabilitation·Hubertus J van HedelVolker Dietz
May 17, 2005·Archives of Physical Medicine and Rehabilitation·Christina V OlesonWilliam P Coleman
Jun 17, 2005·Journal of the Peripheral Nervous System : JPNS·James M Kennedy, Douglas W Zochodne
Oct 1, 2005·Journal of Rehabilitation Research and Development·Marcel P J M Dijkers
Oct 28, 2005·American Journal of Physical Medicine & Rehabilitation·Kristjan T RagnarssonRalph J Marino
Nov 22, 2005·The Journal of Spinal Cord Medicine·Ralph J MarinoUNKNOWN ASIA Neurological Standards Committee 2002
Mar 1, 2006·Neurology·B DobkinUNKNOWN Spinal Cord Injury Locomotor Trial Group
Dec 21, 2006·Spinal Cord·J D SteevesUNKNOWN International Campaign for Cures of Spinal Cord Injury Paralysis
May 18, 2007·Neurorehabilitation and Neural Repair·John F DitunnoUNKNOWN Spinal Cord Injury Locomotor Trial Group
Jun 7, 2007·Journal of Rehabilitation Research and Development·Peter H EllawayGordana Savic
Jun 7, 2007·Journal of Rehabilitation Research and Development·Gordana SavicAlessia Nicotra
Jun 7, 2007·Journal of Rehabilitation Research and Development·Ralph J Marino
Feb 2, 2008·AJNR. American Journal of Neuroradiology·K ShanmuganathanS E Mirvis
Mar 22, 2008·BMJ : British Medical Journal·Fred H Geisler
Jun 27, 2008·Journal of Neurotrauma·Armin CurtUNKNOWN EM-SCI Study Group

❮ Previous
Next ❯

Citations

Jul 21, 2012·ACS Chemical Neuroscience·Giuseppe PeralePietro Veglianese
Mar 1, 2012·Journal of Neurotrauma·Marco D SoraniJacqueline C Bresnahan
Jan 25, 2013·Disability and Rehabilitation·Giorgio ScivolettoMarco Molinari
Oct 29, 2013·PM & R : the Journal of Injury, Function, and Rehabilitation·Amie McLainJohn F Ditunno
Feb 19, 2013·PM & R : the Journal of Injury, Function, and Rehabilitation·John F Ditunno, Richard E Verville
Apr 20, 2013·Physical Medicine and Rehabilitation Clinics of North America·Elizabeth C HardinRonald J Triolo
May 23, 2012·Archives of Physical Medicine and Rehabilitation·David S TulskyJeanne Zanca
Mar 6, 2012·Archives of Physical Medicine and Rehabilitation·Rob Labruyère, Hubertus J van Hedel
Apr 8, 2017·Journal of Neurotrauma·Kathirkamanathan ShanmuganathanStuart E Mirvis
Jan 1, 2012·Journal of Functional Biomaterials·Filippo RossiGiuseppe Perale
May 18, 2011·Brain : a Journal of Neurology·Céline R GillebertRik Vandenberghe
May 2, 2021·Revue neurologique·B Perrouin-VerbeM Le Fort

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.