A Single Dermatome Clinical Prediction Rule for Independent Walking 1 Year After Spinal Cord Injury.
Andrew C Smith, Christina Draganich, Wesley A Thornton and 7 others
PMID 37414239WHAT IT FOUND
Normal pinprick at both lateral heels within 31 days after spinal cord injury was associated with 86% reporting independent walking at 1 year.
Any pinprick at either heel was associated with 76%.
Key findings
01In the validation dataset, normal pinprick sensation at both S1 dermatomes was associated with 86% of people reporting independent walking at 1 year.
02In the validation dataset, any pinprick sensation at either S1 dermatome was associated with 76% of people reporting independent walking at 1 year.
03In the AIS B and C validation subgroup, normal pinprick sensation at both S1 dermatomes was associated with 67% of people reporting independent walking at 1 year.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study included only traumatic spinal cord injury cases with required sensory and 1-year walking data, so it may not apply to non-traumatic injury or incomplete records. The walking outcome was self-reported and included walking with or without a mobility aid, so it may not match measured walking performance. The prediction rule was less accurate for AIS B and C injuries, with 67% accuracy in the validation subgroup. The study used data from United States centers, so it may not apply to other countries or clinical settings. The lumbar SCI subset was small, with 185 people analyzed, and when neither S1 dermatome had any pinprick, only 44% did not report independent walking. The earliest pinprick testing subgroup was small, with 49 people analyzed, so time-window results should be interpreted cautiously. Forty-five validation participants were excluded from injury-level analyses because neurologic injury level data were missing.
Declared interests
No conflicts-of-interest declaration appears in the supplied text. The article metadata lists Research Support, N.I.H., Extramural.
The easy way to misread this
Do not read the 86% figure as proof that the pinprick test causes walking recovery. It is a retrospective prediction of self-reported walking at 1 year, and accuracy is lower for AIS B and C injuries.