Ann Rehabil Med.  2018 Aug;42(4):536-541. 10.5535/arm.2018.42.4.536.

Validation of Korean Version of Coma Recovery Scale-Revised (K-CRSR)

Affiliations
  • 1Department of Physical and Rehabilitation Medicine, Inha University College of Medicine, Incheon, Korea. rmjung@inha.ac.kr
  • 2Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul, Korea.

Abstract


OBJECTIVE
To determine the validity and reliability of the Korean version of the Coma Recovery Scale-Revised (K-CRSR) for evaluation of patients with a severe brain lesion.
METHODS
With permission from Giacino, the developer of the Coma Recovery Scale Revised (CRSR), the scale was translated into Korean and back-translated into English by a Korean physiatrist highly proficient in English, and then verified by the original developer. Adult patients with a severe brain lesion following traumatic brain injury, stroke, or hypoxic brain injury were examined. To assess the inter-rater reliability, all patients were tested with K-CRSR by two physiatrists individually. To determine intra-rater reliability, the same test was re-administered by the same physiatrists after three days.
RESULTS
Inter-rater reliability (k=0.929, p < 0.01) and intra-rater reliability (k=0.938, p < 0.01) were both high for total K-CRSR scores. Inter- and intra-rater agreement rates were very high (94.9% and 97.4%, respectively). The total K-CRSR score was significantly correlated with K-GCS (r=0.894, p < 0.01), demonstrating sufficient concurrent validity.
CONCLUSION
K-CRSR is a reliable and valid instrument for the assessment of patients with brain injury by trained physiatrists. This scale is useful in differentiating patients in minimally conscious state from those in vegetative state.

Keyword

Vegetative state; Minimally conscious state; Coma Recovery Scale Revised; Consciousness

MeSH Terms

Adult
Brain
Brain Injuries
Coma*
Consciousness
Humans
Persistent Vegetative State
Reproducibility of Results
Stroke

Reference

1. Multi-Society Task Force on PVS. Medical aspects of the persistent vegetative state. N Engl J Med. 1994; 330:1499–508.
2. Giacino JT, Ashwal S, Childs N, Cranford R, Jennett B, Katz DI, et al. The minimally conscious state: definition and diagnostic criteria. Neurology. 2002; 58:349–53.
Article
3. Schnakers C, Vanhaudenhuyse A, Giacino J, Ventura M, Boly M, Majerus S, et al. Diagnostic accuracy of the vegetative and minimally conscious state: clinical consensus versus standardized neurobehavioral assessment. BMC Neurol. 2009; 9:35.
Article
4. Giacino JT, Kalmar K, Whyte J. The JFK Coma Recovery Scale-Revised: measurement characteristics and diagnostic utility. Arch Phys Med Rehabil. 2004; 85:2020–9.
5. Schnakers C, Majerus S, Giacino J, Vanhaudenhuyse A, Bruno MA, Boly M, et al. A French validation study of the Coma Recovery Scale-Revised (CRS-R). Brain Inj. 2008; 22:786–92.
Article
6. Sacco S, Altobelli E, Pistarini C, Cerone D, Cazzulani B, Carolei A. Validation of the Italian version of the Coma Recovery Scale-Revised (CRS-R). Brain Inj. 2011; 25:488–95.
Article
7. Tamashiro M, Rivas ME, Ron M, Salierno F, Dalera M, Olmos L. A Spanish validation of the Coma Recovery Scale-Revised (CRS-R). Brain Inj. 2014; 28:1744–7.
Article
8. Di H, He M, Zhang Y, Cheng L, Wang F, Nie Y, et al. Chinese translation of the coma recovery scale-revised. Brain Inj. 2017; 31:363–5.
Article
9. Giacino JT, Zasler ND. Outcome after severe traumatic brain injury: coma, the vegetative state, and the minimally responsive state. J Head Trauma Rehabil. 1995; 10:40–56.
Article
10. Gill-Thwaites H. Lotteries, loopholes and luck: misdiagnosis in the vegetative state patient. Brain Inj. 2006; 20:1321–8.
Article
11. Childs NL, Mercer WN, Childs HW. Accuracy of diagnosis of persistent vegetative state. Neurology. 1993; 43:1465–7.
Article
12. Andrews K, Murphy L, Munday R, Littlewood C. Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit. BMJ. 1996; 313:13–6.
Article
13. Bender A, Jox RJ, Grill E, Straube A, Lule D. Persistent vegetative state and minimally conscious state: a systematic review and meta-analysis of diagnostic procedures. Dtsch Arztebl Int. 2015; 112:235–42.
14. Plum F, Posner JB. The diagnosis of stupor and coma. Contemp Neurol Ser. 1972; 10:1–286.
15. Schnakers C, Giacino J, Kalmar K, Piret S, Lopez E, Boly M, et al. Does the FOUR score correctly diagnose the vegetative and minimally conscious states? Ann Neurol. 2006; 60:744–5.
Article
16. Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975; 1:480–4.
17. Lovstad M, Froslie KF, Giacino JT, Skandsen T, Anke A, Schanke AK. Reliability and diagnostic characteristics of the JFK coma recovery scale-revised: exploring the influence of rater’s level of experience. J Head Trauma Rehabil. 2010; 25:349–56.
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