title: Interrater reliability of the Neuromuscular Recovery Scale for spinal cord injury.
abstract: OBJECTIVE
  To determine the interrater reliability of the Neuromuscular Recovery Scale (NRS), an outcome measure designed to classify people with complete or incomplete spinal cord injury (SCI) into 4 phase-of-injury groups by assessing motor performance based on normal preinjury function and disallowing use of compensation for 4 treadmill-based items and 6 overground/mat items.
  
  
  METHODS
  Masked comparison, multicenter observational study.
  
  
  METHODS
  Outpatient rehabilitation.
  
  
  METHODS
  Raters (N=14) and a criterion standard expert assigned scores to 10 video NRS assessments of persons with SCI. The raters were volunteers from the NeuroRecovery Network.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Interrater reliability measured with the Kendall coefficient of concordance (W).
  
  
  RESULTS
  Interrater reliability was generally strong (W=.91-.98; 95% confidence interval [CI], .65-.99), while lower reliability occurred for treadmill stand retraining (W=.87; 95% CI, .06-1) and seated trunk extension (W=.82; 95% CI, .28-.94). Less experienced raters assigned slightly lower scores than the expert for most items, but the difference was less than half a point and did not weaken concordance.
  
  
  CONCLUSIONS
  NRS had strong interrater reliability, a necessary first step in establishing its utility as a clinical and research outcome measure.
authors.affiliation: School of Health and Rehabilitation Sciences, The Ohio State University, Columbus, OH. Electronic address: Basso.2@osu.edu.
authors.forename: D Michele
authors.initials: DM
authors.lastname: Basso
authors.affiliation: Division of Occupational Therapy, Medical University of South Carolina, Charleston, SC.
authors.forename: Craig
authors.initials: C
authors.lastname: Velozo
authors.affiliation: Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY.
authors.forename: Doug
authors.initials: D
authors.lastname: Lorenz
authors.affiliation: Department of Occupational Therapy, University of Florida, Gainesville, FL.
authors.forename: Sarah
authors.initials: S
authors.lastname: Suter
authors.affiliation: Department of Neurological Surgery and Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Behrman
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010045:Outpatients; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000534:rehabilitation*
keywords: Patient outcome assessment; Recovery of function; Rehabilitation