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Severity score system for progressive myelopathy: development and validation of a new clinical scale.
[adrenomyeloneuropathy]
Progressive
myelopathies
can
be
secondary
to
inborn
errors
of
metabolism
(
IEM
)
such
as
mucopolysaccharidosis
,
mucolipidosis
,
and
adrenomyeloneuropathy
.
The
available
scale
,
Japanese
Orthopaedic
Association
(
JOA
)
score
,
was
validated
only
for
degenerative
vertebral
diseases
.
Our
objective
is
to
propose
and
validate
a
new
scale
addressing
progressive
myelopathies
and
to
present
validating
data
for
JOA
in
these
diseases
.
A
new
scale
,
Severity
Score
System
for
Progressive
Myelopathy
(
SSPROM
)
,
covering
motor
disability
,
sphincter
dysfunction
,
spasticity
,
and
sensory
losses
.
Inter-
and
intra-rater
reliabilities
were
measured
.
External
validation
was
tested
by
applying
JOA
,
the
Expanded
Disability
Status
Scale
(
EDSS
)
,
the
Barthel
index
,
and
the
Osame
Motor
Disability
Score
.
Thirty
-
eight
patients
,
17
with
adrenomyeloneuropathy
,
3
with
mucopolysaccharidosis
I
,
3
with
mucopolysaccharidosis
IV
,
2
with
mucopolysaccharidosis
VI
,
2
with
mucolipidosis
,
and
11
with
human
T
-
cell
lymphotropic
virus
type
-
1
(
HTLV-
1
)
-
associated
myelopathy
participated
in
the
study
.
The
mean
±
SD
SSPROM
and
JOA
scores
were
74
.
6
±
11
.
4
and
12
.
4
±
2
.
3
,
respectively
.
Construct
validity
for
SSPROM
(
JOA
:
r
=
0
.
84
,
P
<
0
.
0001
;
EDSS
:
r
=
-
0
.
83
,
P
<
0
.
0001
;
Barthel
:
r
=
0
.
56
,
P
<
0
.
002
;
Osame
:
r
=
-
0
.
94
,
P
<
0
.
0001
)
and
reliability
(
intra-rater
:
r
=
0
.
83
,
P
<
0
.
0001
;
inter-rater
:
r
=
0
.
94
,
P
<
0
.
0001
)
were
demonstrated
.
The
metric
properties
of
JOA
were
similar
to
those
found
in
SSPROM
.
Several
clinimetric
requirements
were
met
for
both
SSPROM
and
JOA
scales
.
Since
SSPROM
has
a
wider
range
,
it
should
be
useful
for
follow-up
studies
on
IEM
myelopathies
.
Diseases
Validation
Diseases presenting
"to present validating data for joa in these diseases"
symptom
adrenomyeloneuropathy
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