Development and validation of a neuromotor function evaluation system for patients with spinal cord injury

Yang Jin; Xu Yan; Chang Jie

doi:10.3760/j.issn.1673-4777.2026.06.011

Abstract：Objective To develop and validate a multidimensional neuromotor function evaluation system suitable for clinical application in Chinese patients with spinal cord injury.Methods An initial item pool was established through systematic literature review and semi-structured interviews.The modified Delphi method with two rounds involving 24 experts was adopted for item screening.Item analysis,reliability and validity tests,and predictive validity evaluation were performed in 225,125 and 368 patients respectively.Results Item analysis showed satisfactory discriminatory ability of all items.Reliability analysis presented that the overall Cronbach's αcoefficient was 0.872,the intraclass correlation coefficient(ICC)for inter-rater reliability was 0.963,and the ICC for test-retest reliability was 0.945.Validity analysis revealed good construct validity with a cumulative variance contribution rate of 71.3％.The total score was highly correlated with the American Spinal Injury Association motor score and the spinal cord independence measure Ⅲ total score(r=0.784,0.853,respectively).Predictive validity analysis showed that the area under the curve of the system total score for predicting functional household ambulation at 6 months was 0.934,with an optimal cut-off value of 68 points(sensitivity 89.5％,specificity 86.1％).Patients stratified into low,medium and high rehabilitation potential groups according to the cut-off value showed a significant gradient in functional achievement rate(8.7％,47.1％,89.5％,P＜0.001).Conclusion The newly constructed evaluation system has favorable psychometric properties and excellent clinical predictive performance.It realizes the transition from"injury diagnosis"to"functional profiling",and can serve as a standardized tool for clinical rehabilitation assessment and decision-making.