Abstract
Study design:
Psychometric study.
Objectives:
To determine the intra- and inter-rater reliability and content validity of the International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set (ISCIMSBDS).
Setting:
Four centers with one in each of the countries in Australia, England, India and the United States of America.
Methods:
A total of 117 participants with a C2 to S1 neurological level and American Spinal Injury Association Impairment Scale A to D injury were recruited. The median (interquartile range) time since injury was 9 years (2–29). Fifty-seven participants were assessed by the same assessor, and 60 participants were assessed by two different assessors on two different occasions to determine the intra- and inter-rater reliability, respectively. Kappa statistics or crude agreement was used to measure reliability. Content validity was assessed through focus group interviews of people with SCI and health-care professionals.
Results:
The intra-rater reliability ranged from κ=0.62 to 1.00 and crude agreement from 75% to 100% for each of the variables on the ISCIMSBDS. The inter-rater reliability ranged from κ=−0.25 to 1.00, with a diverse crude agreement ranging from 0% to 100%. The inter-rater reliability was unsatisfactory for the following variables: ‘Date of fracture’, ‘Fragility fractures’, ‘Scoliosis, method of assessment’, ‘Other musculoskeletal problems’ and ‘Do any of the above musculoskeletal challenges interfere with your activities of daily living (transfers, walking, dressing, showers, etc.)?’. Results from validity discussions implied no major suggestions for changes.
Conclusion:
Overall, the ISCIMSBDS is reliable and valid, although 5 of the 12 variables may benefit from further refinement.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Biering-Sørensen F, Burns AS, Curt A, Harvey LA, Jane Mulcahey M, Nance PW et al. International spinal cord injury musculoskeletal basic data set. Spinal Cord 2012; 50: 797–802.
Biering-Sørensen F, Charlifue S, DeVivo M, Noonan V, Post M, Stripling T et al. International Spinal Cord Injury Data Sets. Spinal Cord 2006; 44: 530–534.
Sköld C, Levi R, Seiger A . Spasticity after traumatic spinal cord injury: nature, severity, and location. Arch Phys Med Rehabil 1999; 80: 1548–1557.
Kirshblum S . Treatment alternatives for spinal cord injury related spasticity. J Spinal Cord Med 1999; 22: 199–217.
Maynard FM, Karunas RS, Waring WP . Epidemiology of spasticity following traumatic spinal cord injury. Arch Phys Med Rehabil 1990; 71: 566–569.
Hitzig SL, Eng JJ, Miller WC, Sakakibara BM . An evidence-based review of aging of the body systems following spinal cord injury. Spinal Cord 2011; 49: 684–701.
Jiang S-D, Dai L-Y, Jiang L-S . Osteoporosis after spinal cord injury. Osteoporos Int 2006; 17: 180–192.
Vestergaard P, Krogh K, Rejnmark L, Mosekilde L . Fracture rates and risk factors for fractures in patients with spinal cord injury. Spinal Cord 1998; 36: 790–796.
Logan WC, Sloane R, Lyles KW, Goldstein B, Hoenig HM . Incidence of fractures in a cohort of veterans with chronic multiple sclerosis or traumatic spinal cord injury. Arch Phys Med Rehabil 2008; 89: 237–243.
Stover SL, Hataway CJ, Zeiger HE . Heterotopic ossification in spinal cord-injured patients. Arch Phys Med Rehabil 1975; 56: 199–204.
Reznik JE, Biros E, Marshall R, Jelbart M, Milanese S, Gordon S et al. Prevalence and risk-factors of neurogenic heterotopic ossification in traumatic spinal cord and traumatic brain injured patients admitted to specialised units in Australia. J Musculoskelet Neuronal Interact 2014; 14: 19–28.
Diong J, Harvey LA, Kwah LK, Eyles J, Ling MJ, Ben M et al. Incidence and predictors of contracture after spinal cord injury—a prospective cohort study. Spinal Cord 2012; 50: 579–584.
Harvey LA, Glinsky JA, Katalinic OM, Ben M . Contracture management for people with spinal cord injuries. NeuroRehabilitation 2011; 28: 17–20.
Allam AM, Schwabe AL . Neuromuscular scoliosis. PM R 2013; 5: 957–963.
Anastasi A, Urbina S. Psychological Testing. Prentice-Hall: Upper Saddle River, NJ, USA, 1997, pp 114.
Foxcroft C, Paterson H, Le Roux N, Herbst D Psychological Assessment in South Africa: A Needs Analysis: The Test Use Patterns and Needs Of Psychological Assessment Practitioners: Final Report, July, Human Sciences Research Council, Pretoria, South Africa, 2004, pp 48 and 73.
Sim J, Wright CC . The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther 2005; 85: 257–268.
Biering-Sørensen F, Alexander MS, Burns S, Charlifue S, DeVivo M, Dietz V et al. Recommendations for translation and reliability testing of international spinal cord injury data sets. Spinal Cord 2011; 49: 357–360.
OpenClinica, https://www.openclinica.com/ (accessed 27 January 2016).
FDA. Regulatory Information, http://www.fda.gov/RegulatoryInformation/Guidances/ucm125067.htm (accessed 27 January 2016).
Widerström-Noga E, Biering-Sørensen F, Bryce TN, Cardenas DD, Finnerup NB, Jensen MP et al. The International Spinal Cord Injury Pain Basic Data Set (version 2.0). Spinal Cord 2014; 52: 282–286.
Acknowledgements
Thanks to all the individuals with SCI who participated in the study. The database was developed by Knud Mejer Nelausen, IT Coordinator, Clinical Research Unit, Oncology Department, Herlev University Hospital, Copenhagen, Denmark. All authors were supported by their institutions’ internal funds.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Appendix
Appendix

Rights and permissions
About this article
Cite this article
Baunsgaard, C., Chhabra, H., Harvey, L. et al. Reliability of the International Spinal Cord Injury Musculoskeletal Basic Data Set. Spinal Cord 54, 1105–1113 (2016). https://doi.org/10.1038/sc.2016.42
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2016.42
This article is cited by
-
Reliability of the International Spinal Cord Injury Upper Extremity Basic Data Set
Spinal Cord (2018)
-
Reliability of the International Spinal Cord Injury Musculoskeletal Basic Data Set; methodological and statistical issue to avoid misinterpretation
Spinal Cord Series and Cases (2016)
-
Response to: Reliability Of the International Spinal Cord Injury Musculoskeletal Basic Data Set; Methodological and Statistical Issue to Avoid Misinterpretation
Spinal Cord Series and Cases (2016)


