Severity score system for progressive myelopathy: development and validation of a new clinical scale
AUTOR(ES)
Castilhos, R.M., Blank, D., Netto, C.B.O., Souza, C.F.M., Fernandes, L.N.T., Schwartz, I.V.D., Giugliani, R., Jardim, L.B.
FONTE
Brazilian Journal of Medical and Biological Research
DATA DE PUBLICAÇÃO
2012-07
RESUMO
Progressive myelopathies can be secondary to inborn errors of metabolism (IEM) such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA) score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM), covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS), the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1)-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001) and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001) were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.
Documentos Relacionados
- CERVICAL SPONDYLOTIC MYELOPATHY: CLINICAL CASES AND PHYSIOTHERAPY
- Some clinical and pathologic observations on chronic myelopathy: a variant of multiple sclerosis.
- Tuberculous myelopathy: a serial MRI study.
- PMC Patient Severity Scale: derivation and validation.
- The spinal cord in rheumatoid arthritis with clinical myelopathy: a computed myelographic study.