title: Test-retest reliability of the Neuromuscular Recovery Scale.
abstract: OBJECTIVE
  To determine the test-retest reliability of the Neuromuscular Recovery Scale (NRS), a measure to classify lower extremity and trunk recovery of individuals with spinal cord injury (SCI) to typical preinjury performance of functional tasks without use of external and behavioral compensation.
  
  
  METHODS
  Multicenter observational study.
  
  
  METHODS
  Five outpatient rehabilitation clinics.
  
  
  METHODS
  Physical therapists (N=13), trained and competent in conducting NRS, rated outpatients with SCI (N=69) using the NRS. Testing occurred on 2 days, separated by 24 to 48 hours, on the same patient by the same therapist.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Spearman rank correlation coefficients to compare NRS results. The NRS scores of motor performance were based on normal, preinjury function on 11 items: 4 treadmill-based items (standing and stepping), 7 overground/mat items (sitting, sit-up, reverse sit-up, trunk extension, sit to stand, standing, walking).
  
  
  RESULTS
  Test-retest reliability was very strong for the NRS items. Ten of the 11 items exhibited Spearman correlation coefficients ≥.92, and lower bounds of the 95% confidence intervals (CIs) for these items met or exceeded .83. The exception was stand retraining (ρ=.84; 95% CI, .68-.96). The test-retest reliability of the measurement model-derived summary score was very strong (ρ=.99; 95% CI, .96-.99).
  
  
  CONCLUSIONS
  The NRS had excellent test-retest reliability when conducted by trained therapists in adults with chronic SCI across all levels of injury severity. All raters had undergone standardized training in use of the NRS. The minimal requirement of training to achieve test-retest reliability has not been established.
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, KY; Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY. Electronic address: AndreaBehrman@catholichealth.net.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Behrman
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 Occupational Therapy, University of Florida, Gainesville, FL.
authors.forename: Sarah
authors.initials: S
authors.lastname: Suter
authors.affiliation: Department of Biostatistics, University of Louisville, Louisville, KY.
authors.forename: Doug
authors.initials: D
authors.lastname: Lorenz
authors.affiliation: Department of Health and Rehabilitation Sciences, Ohio State University, Columbus, OH.
authors.forename: D Michele
authors.initials: DM
authors.lastname: Basso
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D010045:Outpatients; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D015599:Trauma Severity Indices
keywords: Outcome assessment (health care); Recovery of function; Rehabilitation; Spinal cord injuries