Accepted for/Published in: JMIR Research Protocols
Date Submitted: Mar 27, 2025
Open Peer Review Period: Mar 28, 2025 - Apr 10, 2025
Date Accepted: Jun 20, 2025
(closed for review but you can still tweet)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Development of the SCI-BodyMap: Measuring mental body representations in adults with SCI: A study protocol for item generation, reliability, and validity testing
ABSTRACT
Background:
About 69% of Americans with spinal cord injury (SCI) have neuropathic pain. Research suggests that impairments in mental body representations (MBR, i.e., representations of the body in the brain) likely contribute to neuropathic pain. Clinical trials in adults with SCI, focused on restoring MBR, led to improvements in sensation and movement, and neuropathic pain relief. Scales measuring aspects of MBR exist but none of them assess SCI-related MBR impairments.
Objective:
As our first aim, we will generate items of a new MBR scale for adults with SCI (the SCI-BodyMap scale). As our second aim, we will assess inter-rater reliability, test-retest reliability, concurrent validity, face validity, and utility of the SCI-BodyMap scale.
Methods:
Our preliminary work will encompass initial item generation by SB, an Italian Physical Therapist (PT) specialized in Cognitive Multisensory Rehabilitation (CMR), which is a therapeutic approach that focuses on restoring MBR in adults with neurological disorders and/or chronic pain. Further item refinements will be done by Italian PTs (n=7) and Brazilian PTs (n=3) specialized in CMR. In Aim 1, American PTs or Occupational Therapists (OT) (n=8) and adults with SCI (n=8) will provide feedback on the SCI-BodyMap. Then, American PTs (n=3) will administer the SCI-BodyMap to adults with SCI (n=3) and will provide more feedback during an in-person visit. In Aim 2, two assessors will administer the SCI-BodyMap to a sample of adults with SCI (n=30) for inter-rater reliability. The self-report items in the scale will be administered at 2 separate time points to assess test-retest reliability. We will also administer the SCI-BodyMap to uninjured adults (n=30) to identify whether healthy adults score statistically different on the scale than adults with SCI. We will assess concurrent validity through correlations between the MBR scale, the Revised Body Awareness Rating Questionnaire, and the Multidimensional Assessment Interoceptive Awareness-2.
Results:
As of March 2025, we have enrolled 8 PT/OTs and 8 adults with SCI in this study for Aim 1.
Conclusions:
A reliable and valid MBR scale is needed to identify MBR deficits in adults with SCI and evaluate the effects of interventions on MBR outcomes in adults with SCI. Improving MBR can lead to safer, more efficient day-to-day activities such as transfers, functional independence, quality of life, as well as reduced neuropathic pain, spasms, and improved sensorimotor function. Clinical Trial: N/A
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