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CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events

Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
Indexed/Abstracted in: CINAHL, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 2,063

Frequency: Bi-Monthly

ISSN 1973-9087

Online ISSN 1973-9095

 

European Journal of Physical and Rehabilitation Medicine 2015 October;51(5):627-34

    ORIGINAL ARTICLES

An Italian multicentre validation study of the coma recovery scale-revised

Estraneo A. 1, Moretta P. 1, De Tanti A. 2, Gatta G. 3, Giacino J. T. 4, 5, Trojano L. 1, 6, For The Italian Crs-R Multicentre Validation Group

1 Disorders of Consciousness Laboratory, Salvatore Maugeri Foundation, IRCCS Scientific Institute, Telese Terme, Benevento, Italy;
2 Department of Rehabilitation, Cardinal Ferrari Hospital Fontanellato, Parma, Italy;
3 Rehabilitation Medicine Unit, Ravenna Hospital, Ravenna, Italy;
4 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Boston, MA, USA;
5 Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA;
6 Neuropsychology Lab., Department of Psychology, Second University of Naples, Caserta, Italy

BACKGROUND: Rate of misdiagnosis of disorders of consciousness (DoC) can be reduced by employing validated clinical diagnostic tools, such as the Coma Recovery Scale-Revised (CRS-R). An Italian version of the CRS-R has been recently developed, but its applicability across different clinical settings, and its concurrent validity and diagnostic sensitivity have not been estimated yet.
AIM: To perform a multicentre validation study of the Italian version of the Coma Recovery Scale–Revised (CRS-R).
DESIGN: Analysis of inter-rater reliability, concurrent validity and diagnostic sensitivity of the scale.
SETTING: One Intensive Care Unit, 8 Post-acute rehabilitation centres and 2 Long-term facilities
POPULATION: Twenty-seven professionals (physicians, N.=11; psychologists, N.=5; physiotherapists, N.=3; speech therapists, N.=6; nurses, N.=2) from 11 Italian Centres.
METHODS: CRS-R and Disability Rating Scale (DRS) applied to 122 patients with clinical diagnosis of Vegetative State (VS) or Minimally Conscious State (MCS).
RESULTS: CRS-R has good-to-excellent inter-rater reliability for all subscales, particularly for the communication subscale. The Italian version of the CRS-R showed a high sensitivity and specificity in detecting MCS with reference to clinical consensus diagnosis. The CRS-R showed good concurrent validity with the Disability Rating Scale, which had very low specificity with reference to clinical consensus diagnosis.
CONCLUSIONS: The Italian version of the CRS-R is a valid scale for use from the sub-acute to chronic stages of DoC. It can be administered reliably by all members of the rehabilitation team with different specialties, levels of experience and settings.
CLINICAL REHABILITATION IMPACT: The present study promote use of the Italian version of the CRS-R to improve diagnosis of DoC patients, and plan tailored rehabilitation treatment.

language: English


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