Development of a locomotor rating scale for testing motor function in sheep

Erin Brown, Benjamin A. Keller, Christopher D. Pivetti, Nicole A. Sitkin, Aijun Wang, Diana L Farmer, Jacqueline C. Bresnahan

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background/Purpose Research to cure paralysis associated with myelomeningocele (MMC) is ongoing using the fetal sheep model of MMC. Despite decades of research using this model, no standardized motor function assessment exists. The purpose of this study is to develop a sensitive and reliable locomotor scale for assessing the functional status of sheep. Methods Twenty lambs were used to develop and validate the locomotor scale. Lambs (n = 15) underwent a surgically created MMC defect at gestational age (GA) 75 days, followed by repair with various methods at GA 100. One lamb underwent a sham operation (n = 1). Normal lambs (n = 4) served as controls. All lambs were born via spontaneous vaginal delivery, and motor function was assessed for 24 hours. A locomotor rating scale was developed based on behavioral observations of lambs. Inter-rater reliability testing was performed to determine if the scale could be reliably applied by different raters. Results Observations led to the definition of 7 categories of locomotor recovery. A scoring system was developed to rank these categories. The scale captured a wide variety of neurologic outcomes. Inter-rater reliability revealed minimal variability between examiners (average standard deviation ± 0.431). The average score for all raters was within 1 point of the consensus score 100% of the time. Conclusions The sheep locomotor rating scale is capable of capturing subtle differences in neurologic function with minimal inter-rater variability. We propose a standardized rating scale for neurologic outcomes and believe this is a critical component for assessing the validity of experimental treatments to cure paralysis in MMC.

Original languageEnglish (US)
Pages (from-to)617-621
Number of pages5
JournalJournal of Pediatric Surgery
Volume50
Issue number4
DOIs
StatePublished - Apr 1 2015

Fingerprint

Meningomyelocele
Sheep
Nervous System
Paralysis
Gestational Age
Research
Consensus

Keywords

  • fetal surgery
  • locomotion
  • motor function
  • Myelomeningocele
  • spina bifida

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Development of a locomotor rating scale for testing motor function in sheep. / Brown, Erin; Keller, Benjamin A.; Pivetti, Christopher D.; Sitkin, Nicole A.; Wang, Aijun; Farmer, Diana L; Bresnahan, Jacqueline C.

In: Journal of Pediatric Surgery, Vol. 50, No. 4, 01.04.2015, p. 617-621.

Research output: Contribution to journalArticle

Brown, Erin ; Keller, Benjamin A. ; Pivetti, Christopher D. ; Sitkin, Nicole A. ; Wang, Aijun ; Farmer, Diana L ; Bresnahan, Jacqueline C. / Development of a locomotor rating scale for testing motor function in sheep. In: Journal of Pediatric Surgery. 2015 ; Vol. 50, No. 4. pp. 617-621.
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abstract = "Background/Purpose Research to cure paralysis associated with myelomeningocele (MMC) is ongoing using the fetal sheep model of MMC. Despite decades of research using this model, no standardized motor function assessment exists. The purpose of this study is to develop a sensitive and reliable locomotor scale for assessing the functional status of sheep. Methods Twenty lambs were used to develop and validate the locomotor scale. Lambs (n = 15) underwent a surgically created MMC defect at gestational age (GA) 75 days, followed by repair with various methods at GA 100. One lamb underwent a sham operation (n = 1). Normal lambs (n = 4) served as controls. All lambs were born via spontaneous vaginal delivery, and motor function was assessed for 24 hours. A locomotor rating scale was developed based on behavioral observations of lambs. Inter-rater reliability testing was performed to determine if the scale could be reliably applied by different raters. Results Observations led to the definition of 7 categories of locomotor recovery. A scoring system was developed to rank these categories. The scale captured a wide variety of neurologic outcomes. Inter-rater reliability revealed minimal variability between examiners (average standard deviation ± 0.431). The average score for all raters was within 1 point of the consensus score 100{\%} of the time. Conclusions The sheep locomotor rating scale is capable of capturing subtle differences in neurologic function with minimal inter-rater variability. We propose a standardized rating scale for neurologic outcomes and believe this is a critical component for assessing the validity of experimental treatments to cure paralysis in MMC.",
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