Ann Rehabil Med.  2017 Dec;41(6):969-978. 10.5535/arm.2017.41.6.969.

Degree of Contribution of Motor and Sensory Scores to Predict Gait Ability in Patients With Incomplete Spinal Cord Injury

• Moon J
• Yu J
• Choi J
• Kim M
• Min K

• KMID: 2400281
• DOI: http://doi.org/10.5535/arm.2017.41.6.969

Abstract

OBJECTIVE
To identify different contributions of motor and sensory variables for independent ambulation of patients with incomplete spinal cord injury (SCI), and reveal the most significant contributors among the variables.
METHODS
The retrospective study included 30 patients with incomplete SCI and lesions were confirmed by magnetic resonance imaging. Motor and sensory scores were collected according to the International Standards for Neurological Classification of Spinal Cord Injury. The variables were analyzed by plotting ROC (receiver operating characteristic) curves to estimate their differential contributions for independent walking. The most significant functional determinant was identified through the subsequent logistic regression analysis.
RESULTS
Motor and sensory scores were significantly different between the ambulators and non-ambulators. The majority was associated to the function of lower extremities. Calculation of area under ROC curves (AUC) revealed that strength of hip flexor (L2) (AUC=0.905, p < 0.001) and knee extensor (L3) (AUC=0.820, p=0.006) contributed the greatest to independent walking. Also, hip flexor strength (L2) was the single most powerful predictor of ambulation by the logistic regression analysis (odds ratio=6.3, p=0.049), and the model fit well to the data.
CONCLUSION
The most important potential contributor for independent walking in patients with incomplete SCI is the muscle strength of hip flexors, followed by knee extensors compared with other sensory and motor variables.

Keyword

Spinal cord injuries; Locomotion; Muscle strength; Sensation; Rehabilitation

MeSH Terms

Classification
Gait*
Hip
Humans
Knee
Locomotion
Logistic Models
Lower Extremity
Magnetic Resonance Imaging
Muscle Strength
Rehabilitation
Retrospective Studies
ROC Curve
Sensation
Spinal Cord Injuries*
Spinal Cord*
Walking

Figure

• 

  Fig. 1 Receiver operating characteristic (ROC) curves of selected predictors. A total of 69 motor and sensory variables including LEMS, total LT, and PP scores were analyzed to identify their performance to discriminate the ambulators and non-ambulators by ROC curves. Two predictors showed AUC over 0.8 indicating excellent discriminatory accuracy; motor scores of hip flexor (L2, AUC=0.905) and knee extensor (L3, AUC=0.820). M, muscle strength; AUC, area under ROC curve.

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