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The Spastic Paraplegia Rating Scale (SPRS)

A reliable and valid measure of disease severity

From the Hertie Institute for Clinical Brain Research and Department of Neurology (R.S., L.S.), Eberhard Karls University Tübingen, Department of Medical Informatics, Biometry, and Epidemiology (T.H.-L.), Ruhr University Bochum, Department of Neurology (S.K.), Johannes Gutenberg University Mainz, Department of Neurology (J.K.), University of Ulm, Department of Neurology (T.K.), Ludwig Maximilians University Munich, Department of Neuropediatrics and Muscle Disorders (V.M.), University of Freiburg, Department of Neurology (S.O.), Ruhr University Bochum, and Department of Neurology (B.W.), University of Regensburg, Germany.

Address correspondence and reprint requests to Dr. L. Schöls, Department of Neurology and Hertie Institute for Clinical Brain Research, University of Tübingen, Hoppe-Seyler-Str. 3, D-72076 Tübingen, Germany; e-mail: Ludger.Schoels{at}uni-tuebingen.de

Objective: To develop and evaluate a clinical Spastic Paraplegia Rating Scale (SPRS) to measure disease severity and progression.

Methods: A 13-item scale was designed to rate functional impairment occurring in pure forms of spastic paraplegia (SP). Additional symptoms constituting a complicated form of SP are recorded in an inventory. Two independent patient cohorts were evaluated in a two-step validation procedure.

Results: Application of SPRS requires less than 15 minutes and does not require any special equipment, so it is suitable for an outpatient setting. Interrater agreement of SPRS was high (intraclass correlation coefficient = 0.99). Reliability was further supported by high internal consistency (Cronbach = 0.91). SPRS values were almost normally distributed without apparent floor or ceiling effect. Construct validity was shown by high correlation of SPRS to Barthel Index and the International Cooperative Ataxia Rating Scale (convergent validity) and low correlation to Mini-Mental Status Examination (discriminant validity).

Conclusion: The Spastic Paraplegia Rating Scale is a reliable and valid measure of disease severity.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the August 8 issue to find the title link for this article.

Supported by the German Bundesministerium für Bildung und Forschung (grant 01GM0304; GeNeMove).

Disclosure: The authors report no conflicts of interest.

Received October 21, 2005. Accepted in final form April 3, 2006.

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