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

Abstract

ObjectiveTo 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.MethodsWith 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.ResultsInter-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.ConclusionK-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.

Neurobehavioral recovery in patients who emerged from prolonged disorder of consciousness: a retrospective study

“…CRS-R, JFK Coma Recovery Scale-Revised; EDoC, emergence from disorder of consciousness; PDoC, prolonged disorder of consciousness monthly assessments. Even though the CRS-R has served as a useful tool for the differentiation between MCS and VS/ UWS with high reliability, validity, and sensitivity, spontaneous variability of the relevant neuronal or non-neuronal parameters over time in patients with severe disorder of consciousness may lead to spontaneous fluctuations [35,36]. Hence, individual variability on the CRS-R may suggest limited diagnostic accuracy.…”

Safety and therapeutic effects of personalized transcranial direct current stimulation based on electrical field simulation for prolonged disorders of consciousness: study protocol for a multi-center, double-blind, randomized controlled trial

“…K-CRS-R: The CRS is a neurobehavioral assessment instrument used to evaluate the state of consciousness of patients with severe brain injury; it is able to predict the treatment outcome with high accuracy. The CRS-R was released in 2004 and reflects the diagnostic criteria for MCS developed by the Aspen Workgroup in 2002 ( 2 ); it is the most effective tool for assessing long-term DOC patients and is recommended by the American Congress of Rehabilitation Medicine ( 17 ). The CRS-R distinguishes MCS from VS based on six sub-domains (auditory, visual, motor, oral movement/language, communication, and arousal).…”

Behavioral Assessment of Patients with Disorders of Consciousness

“…Extensions and adaptations of the CRS-R have expanded its use globally and to special populations and clinical questions. The CRS-R has been translated and validated in Spanish, 30 Italian, 31 32 33 French, 34 Portuguese, 35 Norwegian, 36 Russian, 37 German, 38 Polish, 39 Korean, 40 and Chinese 41 42 with validated versions forthcoming in Japanese, Hebrew and Brazilian Portuguese. The CRS-R is also available in Dutch, Swedish, Danish, and Greek, but has not been validated in these languages.…”