title: A new grading for easy and concise description of functional status after spinal cord lesions.
abstract: BACKGROUND
  Disability scales do not enable the transmission of concise, meaningful and daily function description for clinical purposes.
  
  
  METHODS
  Cross-sectional statistical analysis of 328 patients' Spinal Cord Independence Measure (SCIM) III item scores (SIS).
  
  
  OBJECTIVE
  To develop a concise and clinically interpretable data-based characterization of daily task accomplishment for patients with spinal cord lesions (SCLs).
  
  
  METHODS
  Multi-center study at 13 spinal units in 6 countries.
  
  
  METHODS
  Patients were grouped into clusters characterized by smaller differences between the patients' SIS within the clusters than between their centers, using the k-medoides algorithm. The number of clusters (k) was chosen according to the percent of SIS variation they explained and the clinical distinction between them.
  
  
  RESULTS
  Analysis showed that k=8 SIS clusters offer a good description of the patient population. The eight functional clusters were designated as A-H, each cluster (grade) representing a combination of task accomplishments. Higher grades were usually (but not always) associated with patients implementing more difficult tasks. Throughout rehabilitation, the patients' functional grade improved and the distribution of patients with similar functional grades within the total SCIM III score deciles remained stable.
  
  
  CONCLUSIONS
  A new classification based on SIS clusters enables a concise description of overall functioning and task accomplishment distribution in patients with SCL. A software tool is used to identify the patients' functional grade. Findings support the stability and utility of the grades for characterizing the patients' functional status.
authors.affiliation: Loewenstein Rehabilitation Hospital, Department of Spinal Rehabilitation, and the Administration, Raanana, Israel.
authors.forename: V
authors.initials: V
authors.lastname: Bluvshtein
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authors.initials: L
authors.lastname: Front
authors.forename: M
authors.initials: M
authors.lastname: Itzkovich
authors.forename: Y
authors.initials: Y
authors.lastname: Benjamini
authors.forename: T
authors.initials: T
authors.lastname: Galili
authors.forename: I
authors.initials: I
authors.lastname: Gelernter
authors.forename: E
authors.initials: E
authors.lastname: Aidinoff
authors.forename: J
authors.initials: J
authors.lastname: Hart
authors.forename: L
authors.initials: L
authors.lastname: Tesio
authors.forename: F
authors.initials: F
authors.lastname: Biering-Sorensen
authors.forename: C
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authors.lastname: Weeks
authors.forename: M T
authors.initials: MT
authors.lastname: Laramee
authors.forename: C
authors.initials: C
authors.lastname: Craven
authors.forename: S L
authors.initials: SL
authors.lastname: Hitzig
authors.forename: E
authors.initials: E
authors.lastname: Glaser
authors.forename: G
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authors.lastname: Zeilig
authors.forename: S
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authors.lastname: Aito
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authors.lastname: Scivoletto
authors.forename: M
authors.initials: M
authors.lastname: Mecci
authors.forename: R J
authors.initials: RJ
authors.lastname: Chadwick
authors.forename: W S
authors.initials: WS
authors.lastname: El Masry
authors.forename: A
authors.initials: A
authors.lastname: Osman
authors.forename: C A
authors.initials: CA
authors.lastname: Glass
authors.forename: P
authors.initials: P
authors.lastname: Silva
authors.forename: B M
authors.initials: BM
authors.lastname: Soni
authors.forename: B P
authors.initials: BP
authors.lastname: Gardner
authors.forename: G
authors.initials: G
authors.lastname: Savic
authors.forename: E M
authors.initials: EM
authors.lastname: Bergström
authors.forename: A
authors.initials: A
authors.lastname: Catz
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D000368:Aged; D000465:Algorithms; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005242:Fecal Incontinence / Q000209:etiology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011782:Quadriplegia / Q000209:etiology / Q000534:rehabilitation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*