Correlation Between Neurologic Impairment Grade and Ambulation Status in the Adult Spina Bifida Population.

The study reviewed clinic records from each patient's most recent visit, so it cannot show that impairment grade causes ambulation status. Some muscle strength data were missing, and the authors substituted other muscle tests for the Broughton and ISNCSCI scales, which may have moved some patients into different motor levels. Multiple examiners performed muscle testing, which may have introduced variation, although a single attending physiatrist conducted or verified exams. The study used motor testing only, so it may not capture all factors related to walking. The Hoffer ambulation scale has low sensitivity, which may limit how reliably it can be correlated with impairment scales. The sample was mostly white and non-Hispanic/non-Latino, so results may not apply to other demographic groups. The study was done at one adult spina bifida clinic, so patient mix and testing practices may differ elsewhere.

The supplied metadata lists research support as Research Support, U.S. Gov't, P.H.S. No author conflicts of interest or industry funding are reported in the supplied text.

Do not conclude that the Broughton scale should be used routinely because it had the strongest correlation. It uses many muscle tests that can be hard to perform in a busy clinic, and the simpler NSBPR scale was nearly as strong.