The diagnostic accuracy of self-report for determining S4-5 sensory and motor function in people with spinal cord injury

Abstract

Study design:A diagnostic accuracy study. Objectives: The objective was to determine the ability of people with SCI to accurately self-report S4-5 sensory and motor function. Setting: Outpatient clinic, Sydney, Australia. Methods: A consecutive series of thirty-four people who had sustained a SCI more than 1 year before the study, and who were attending an outpatient medical clinic were recruited. They were assessed on two occasions. On the first occasion, ability to self-report S4-5 sensory and motor function was assessed with four questions. On the second occasion, a rehabilitation physician performed a physical examination to determine participants S4-5 sensory and motor function. The rehabilitation physician was unaware of the results of participants self-report. Participants self-reports were compared with results from the physical examination using likelihood ratios. Results: The likelihood ratios (95% CI) associated with a positive response to the sensory and motor questions were 1.92 (1.0-3.6) and 2.4 (1.2-4.9), respectively. The likelihood ratios associated with a negative response to the sensory and motor questions were 0.1 (0.0-0.6) and 0.4 (0.1-1.2), respectively. Conclusion: People with SCI are reasonably accurate at self-reporting S4-5 sensory and motor function, although there is a high rate of false positives for S4-5 motor in those with motor levels below T10. In some situations it may be appropriate to use self-report rather than a physical examination to determine S4-5 sensory and motor function. © 2012 International Spinal Cord Society All rights reserved.