{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:07:19Z","timestamp":1789416439542,"version":"build-2803163510"},"reference-count":29,"publisher":"American Spinal Injury Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,3,1]]},"abstract":"<jats:p>Background: In synergy with the mounting scientific evidence for the capacity of recovery after spinal cord injury (SCI) and training, new evidence-based therapies advancing neuromuscular recovery are emerging. There is a parallel need for outcome instruments that specifically address recovery. The Pediatric Neuromuscular Recovery Scale (Pediatric NRS) is one example with established content validity to assess neuromuscular capacity within task performance. Objective: The objective of this study was to determine interrater reliability of the Pediatric NRS to classify motor capacity in children after SCI. Methods: Pediatric physicians (3), occupational therapists (5), and physical therapists (6) received standardized training in scoring the scale, then rated video assessments of 32 children post SCI, 2\u201312 years of age, 78% non-ambulatory. Interrater reliability was analyzed using Kendall coefficient of concordance for individual Pediatric NRS items and overall score. Results: The interrater reliability coefficient was determined to be near 1 for the overall Pediatric NRS score (ICC = 0.966; 95% CI, 0.89\u20130.98). Twelve of 16 individual items exhibited high concordance coefficients (Kendall's W \u2265 0.8) and four items demonstrated concordance coefficients, &amp;lt; 0.8 and &amp;gt; 0.69. Interrater reliability was equivalent among groups defined by age and neurological level, but lower among non-ambulatory individuals. Conclusion: Strong interrater reliability was demonstrated by pediatric clinicians who scored children with SCI using the Pediatric NRS.<\/jats:p>","DOI":"10.1310\/sci2502-121","type":"journal-article","created":{"date-parts":[[2019,4,30]],"date-time":"2019-04-30T19:48:36Z","timestamp":1556653716000},"page":"121-131","source":"Crossref","is-referenced-by-count":9,"title":["Interrater Reliability of the Pediatric Neuromuscular Recovery Scale for Spinal Cord Injury"],"prefix":"10.46292","volume":"25","author":[{"given":"Andrea L.","family":"Behrman","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Louisville, Louisville, Kentucky"},{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shelley A.","family":"Trimble","sequence":"additional","affiliation":[{"name":"Spinal Cord Medicine Program, Frazier Rehab Institute, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura C.","family":"Argetsinger","sequence":"additional","affiliation":[{"name":"Spinal Cord Medicine Program, Frazier Rehab Institute, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MacKenzie T.","family":"Roberts","sequence":"additional","affiliation":[{"name":"Spinal Cord Medicine Program, Frazier Rehab Institute, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MJ","family":"Mulcahey","sequence":"additional","affiliation":[{"name":"Jefferson College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Clayton","sequence":"additional","affiliation":[{"name":"Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky"},{"name":"Kosair Charities Center for Pediatric NeuroRecovery, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary E.","family":"Gregg","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Louisville, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth M.","family":"Ardolino","sequence":"additional","affiliation":[{"name":"Doctor of Physical Therapy Program - Austin, University of St. Augustine for Health Sciences, Austin, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"5","key":"2021012919253451900_i1082-0744-25-2-121-b1","doi-asserted-by":"crossref","first-page":"580","DOI":"10.2522\/ptj.20070315","article-title":"Locomotor training restores walking in a nonambulatory child with chronic, severe, incomplete cervical spinal cord injury","volume":"88","author":"Behrman","year":"2008","journal-title":"Phys Ther"},{"issue":"4","key":"2021012919253451900_i1082-0744-25-2-121-b2","doi-asserted-by":"crossref","first-page":"279","DOI":"10.1310\/sci1904-279","article-title":"Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: Pilot study","volume":"19","author":"Kapadia","year":"2013","journal-title":"Top Spinal Cord Inj Rehabil"},{"issue":"6","key":"2021012919253451900_i1082-0744-25-2-121-b3","doi-asserted-by":"crossref","first-page":"721","DOI":"10.1097\/WCO.0000000000000382","article-title":"Epidural and transcutaneous spinal electrical stimulation for restoration of movement after incomplete and complete spinal cord injury","volume":"29","author":"Mayr","year":"2016","journal-title":"Curr Opin Neurol"},{"issue":"9","key":"2021012919253451900_i1082-0744-25-2-121-b4","doi-asserted-by":"crossref","first-page":"1787","DOI":"10.1089\/neu.2016.4516","article-title":"Effects of stand and step training with epidural stimulation on motor function for standing in chronic complete paraplegics","volume":"34","author":"Rejc","year":"2017","journal-title":"J Neurotrauma"},{"issue":"Pt 5","key":"2021012919253451900_i1082-0744-25-2-121-b5","doi-asserted-by":"crossref","first-page":"1394","DOI":"10.1093\/brain\/awu038","article-title":"Altering spinal cord excitability enables voluntary movements after chronic complete paralysis in humans","volume":"137","author":"Angeli","year":"2014","journal-title":"Brain"},{"issue":"5","key":"2021012919253451900_i1082-0744-25-2-121-b6","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1038\/s41393-017-0015-5","article-title":"Considerations and recommendations for selection and utilization of upper extremity clinical outcome assessments in human spinal cord injury trials","volume":"56","author":"Jones","year":"2018","journal-title":"Spinal Cord"},{"issue":"8","key":"2021012919253451900_i1082-0744-25-2-121-b7","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1016\/j.apmr.2015.03.022","article-title":"Test-retest reliability of the Neuromuscular Recovery Scale","volume":"96","author":"Behrman","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"2021012919253451900_i1082-0744-25-2-121-b8","doi-asserted-by":"crossref","first-page":"1385","DOI":"10.1016\/j.apmr.2015.04.004","article-title":"Validity of the Neuromuscular Recovery Scale: A measurement model approach","volume":"96","author":"Velozo","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"issue":"6","key":"2021012919253451900_i1082-0744-25-2-121-b9","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1177\/1545968315605181","article-title":"Responsiveness of the neuromuscular recovery scale during outpatient activity-dependent rehabilitation for spinal cord injury","volume":"30","author":"Tester","year":"2016","journal-title":"Neurorehabil Neural Repair"},{"issue":"9","key":"2021012919253451900_i1082-0744-25-2-121-b10","doi-asserted-by":"crossref","first-page":"1518","DOI":"10.1016\/j.apmr.2011.04.027","article-title":"Assessment of functional improvement without compensation reduces variability of outcome measures after human spinal cord injury","volume":"93","author":"Behrman","year":"2012","journal-title":"Arch Phys Med Rehabil"},{"issue":"8","key":"2021012919253451900_i1082-0744-25-2-121-b11","doi-asserted-by":"crossref","first-page":"1397","DOI":"10.1016\/j.apmr.2014.11.026","article-title":"Interrater reliability of the Neuromuscular Recovery Scale for spinal cord injury","volume":"96","author":"Basso","year":"2015","journal-title":"Arch Phys Med Rehabil"},{"issue":"12","key":"2021012919253451900_i1082-0744-25-2-121-b12","doi-asserted-by":"crossref","first-page":"915","DOI":"10.1038\/sc.2012.80","article-title":"Evaluation of newly developed item banks for child-reported outcomes of participation following spinal cord injury","volume":"50","author":"Mulcahey","year":"2012","journal-title":"Spinal Cord"},{"issue":"12","key":"2021012919253451900_i1082-0744-25-2-121-b13","doi-asserted-by":"crossref","first-page":"1183","DOI":"10.1038\/sc.2016.68","article-title":"The Pediatric Measure of Participation (PMoP) Short Forms","volume":"54","author":"Mulcahey","year":"2016","journal-title":"Spinal Cord"},{"issue":"7","key":"2021012919253451900_i1082-0744-25-2-121-b14","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1038\/sc.2015.194","article-title":"Measuring activity limitation outcomes in youth with spinal cord injury","volume":"54","author":"Slavin","year":"2016","journal-title":"Spinal Cord"},{"issue":"12","key":"2021012919253451900_i1082-0744-25-2-121-b15","doi-asserted-by":"crossref","DOI":"10.1038\/sj.sc.3100504","article-title":"SCIM--spinal cord independence measure: A new disability scale for patients with spinal cord lesions","volume":"35","author":"Catz","year":"1997","journal-title":"Spinal Cord"},{"issue":"24","key":"2021012919253451900_i1082-0744-25-2-121-b16","doi-asserted-by":"crossref","first-page":"1926","DOI":"10.1080\/09638280601046302","article-title":"The Spinal Cord Independence Measure (SCIM) version III: Reliability and validity in a multi-center international study","volume":"29","author":"Itzkovich","year":"2007","journal-title":"Disabil Rehabil"},{"issue":"8","key":"2021012919253451900_i1082-0744-25-2-121-b17","doi-asserted-by":"crossref","first-page":"880","DOI":"10.1038\/sc.2011.20","article-title":"United States (US) multi-center study to assess the validity and reliability of the Spinal Cord Independence Measure (SCIM III)","volume":"49","author":"Anderson","year":"2011","journal-title":"Spinal Cord"},{"issue":"2","key":"2021012919253451900_i1082-0744-25-2-121-b18","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1038\/sc.2010.111","article-title":"SCIM III is reliable and valid in a separate analysis for traumatic spinal cord lesions","volume":"49","author":"Bluvshtein","year":"2011","journal-title":"Spinal Cord"},{"issue":"4","key":"2021012919253451900_i1082-0744-25-2-121-b19","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1038\/s41393-017-0036-0","article-title":"Despite limitations in content range, the SCIM-III is reproducible and a valid indicator of physical function in youths with spinal cord injury and dysfunction","volume":"56","author":"Mulcahey","year":"2018","journal-title":"Spinal Cord"},{"issue":"6","key":"2021012919253451900_i1082-0744-25-2-121-b20","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1089\/neu.2017.5195","article-title":"The Graded and Redefined Assessment of Strength, Sensibility, and Prehension Version 2 provides interval measure properties","volume":"35","author":"Velstra","year":"2018","journal-title":"J Neurotrauma"},{"issue":"1 Suppl","key":"2021012919253451900_i1082-0744-25-2-121-b21","doi-asserted-by":"crossref","first-page":"65","DOI":"10.3171\/2012.6.AOSPINE1258","article-title":"Development of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP): Reviewing measurement specific to the upper limb in tetraplegia","volume":"17","author":"Kalsi-Ryan","year":"2012","journal-title":"J Neurosurg Spine"},{"issue":"6","key":"2021012919253451900_i1082-0744-25-2-121-b22","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1097\/PHM.0b013e31824fa6cc","article-title":"Development of an objective test of upper-limb function in tetraplegia: The Capabilities of Upper Extremity Test","volume":"91","author":"Marino","year":"2012","journal-title":"Am J Phys Med Rehabil"},{"issue":"4","key":"2021012919253451900_i1082-0744-25-2-121-b23","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1179\/2045772314Y.0000000272","article-title":"Reliability and validity of the Capabilities of Upper Extremity Test (CUE-T) in subjects with chronic spinal cord injury","volume":"38","author":"Marino","year":"2015","journal-title":"J Spinal Cord Med"},{"key":"2021012919253451900_i1082-0744-25-2-121-b24","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780195342086.001.0001","volume-title":"Locomotor Training: Principles and Practice","author":"Harkema","year":"2011"},{"issue":"4","key":"2021012919253451900_i1082-0744-25-2-121-b25","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1097\/PEP.0000000000000285","article-title":"Development and initial validation of the Pediatric Neuromuscular Recovery Scale","volume":"28","author":"Ardolino","year":"2016","journal-title":"Pediatr Phys Ther"},{"issue":"6","key":"2021012919253451900_i1082-0744-25-2-121-b26","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1179\/107902611X13186000420242","article-title":"Reference for the 2011 revision of the International Standards for Neurological Classification of Spinal Cord Injury","volume":"34","author":"Kirshblum","year":"2011","journal-title":"J Spinal Cord Med"},{"issue":"8","key":"2021012919253451900_i1082-0744-25-2-121-b27","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1016\/j.apmr.2011.03.003","article-title":"Interrater reliability of the International Standards for Neurological Classification of Spinal Cord Injury in youths with chronic spinal cord injury","volume":"92","author":"Mulcahey","year":"2011","journal-title":"Arch Phys Med Rehabil"},{"issue":"1","key":"2021012919253451900_i1082-0744-25-2-121-b28","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/PEP.0b013e31818f5bbd","article-title":"A pilot study of observational motor assessment in infants and toddlers with spinal cord injury","volume":"21","author":"Calhoun","year":"2009","journal-title":"Pediatr Phys Ther"},{"issue":"3","key":"2021012919253451900_i1082-0744-25-2-121-b29","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1080\/01942638.2017.1337662","article-title":"The reliability of the Segmental Assessment of Trunk Control (SATCo) in children with cerebral palsy","volume":"38","author":"Hansen","year":"2018","journal-title":"Phys Occup Ther Pediatr"}],"container-title":["Topics in Spinal Cord Injury Rehabilitation"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/meridian.allenpress.com\/tscir\/article-pdf\/25\/2\/121\/2676975\/sci2502-121.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/meridian.allenpress.com\/tscir\/article-pdf\/25\/2\/121\/2676975\/sci2502-121.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,5]],"date-time":"2023-12-05T20:54:05Z","timestamp":1701809645000},"score":1,"resource":{"primary":{"URL":"https:\/\/meridian.allenpress.com\/tscir\/article\/25\/2\/121\/449325\/Interrater-Reliability-of-the-Pediatric"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,1]]},"references-count":29,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,3,1]]}},"URL":"https:\/\/doi.org\/10.1310\/sci2502-121","relation":{},"ISSN":["1082-0744"],"issn-type":[{"value":"1082-0744","type":"print"}],"subject":[],"published":{"date-parts":[[2019,3,1]]}}}