These include the scale of frankel et al,1 one of the most commonly used systems, and others such as the sunnybrook cord injury scale of tator et al,2 the spinal cord injury severity scale. International standards for the classification of spinal cord. If there is evidence of any motor or sensory function in the area around the anus, one of four classifications is given according to the asia impairment scale. This model systems knowledge translation center fact sheet outlines what adjusting well looks like, what difficulty with adjustment looks like, and offers insight into other common areas of adjustment. Many of these are already being used to assess the outcomes of spinal cord injuries, while others are used in related fields and could be modified for use with spinal cord injury. The level of your injury will determine the effect it will have. Elbow flexorsright c4 elbow flexors left wrist extensors. Asia impairment scale for spinal injury radiology reference. Mar 02, 2017 the frequency with which each behaviour has been performed over the past 3 months is rated using an ordinal scale where 4almost always, 3frequently, 2sometimes, 1rarely and 0never.
Motor function is preserved below neurologic level and more than half of. Waring wp, bieringsorensen f, burns sp, donovan w, graves d, jha a, et al. Asia impairment scale and spinal cord injuries youtube. Isncsci algorithm calculator to score the asia impairment. The better understanding and management of spinal cord injury have led to a reduction in mortality and a higher incidence of incomplete spinal cord damage in those who survive. Doctors use the american spinal injury association asia international standards for neurological classification of spinal cord injury when determining the classification of injuries. The original scim was revised to address substandard reproducibility spinal cord independence measure. Walking ability was quantified using the walking index for spinal cord injury ii scale wisciii 18. Written by zawn villines zawn villines is a writer specializing in health and legal journalism.
C3 in the supraclavicular fossa, at the midclavicular line. From the patients point of view, the impaired functionsthat should receive the most attention for becoming restored are. S3 over the ischial tuberosity or infragluteal fold depending on the patient their skin can move up, down or laterally over the ischii. Adjusting to life after spinal cord injury pdf most people adjust well to life after sci. If you do not have adobe reader, you may download a free copy by clicking on the get acrobat reader image below. The asia impairment scale builds on the earlier frankel scale but includes a number of significant improvements. Spinal cord case sample life care plan potential complications pdf file note. Assessment of spinal cord injury linkedin slideshare. Sensory, but not motor, function is preserved below t. Jun 07, 2016 this is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. The files listed above are pdf files, so you will need to have adobe reader on you system.
Asia impairment scale innervated segments rl sensory motor rl sensory motor this form may be copied freely but should not be altered without permission from the american spinal injury association. Ais a complete classification is defined by the absence of motor and sensory function in the sacral segments s4s5. Elbow flexorsright c4 elbow flexors left wrist extensors c6. These injuries are designated as being grade a on the ais. The asia impairment scale describes a persons functional impairment as a result of their spinal cord injury. Anatomy, careers, and injury prevention student workbook dear students, you are about to embark on a fascinating and sometimes emotional journey to learn about what life is like for young people and their families after they have a brain or spinal cord injury. Please note that the following is my interpretation of the asia classification. Motor function is preserved below the neurological level, and more then half of key muscles below the neurological.
Mar 23, 2017 t12 l1 l2 l3 l4 l5 international standards for the classification of spinal cord injury key sensory points june 2008. American spinal injury association asia impairment scale describes a persons functional impairment as a result of their spinal cord injury. Dietz rehabilitation of locomotion after spinal cord injury in a high personal independency and a good quality of life with little socioeconomic burden. The original scim was revised to address substandard reproducibility pdf pdf document, 284kb document actions. Measures of recovery spinal cord injury research evidence. Abc of spinal cord injury united paralysis foundation. The frequency with which each behaviour has been performed over the past 3 months is rated using an ordinal scale where 4almost always, 3frequently, 2sometimes, 1rarely and 0never. By systematically examining the dermatomes and myotomes, one can determine the cord segments affected by the. This is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. Traumatic brain injury tbi outcome prediction calculator crash. The asiaiscos exam assessment of spinal cord injury level of neurological impairment the asia neurological impairment scale is based on the frankel classification of spinal cord injury. Gait speed and number of steps needed to walk 10 m were assessed using the 10 meters walk.
Asia impairment scale for spinal injury dr francis deng and assoc prof frank gaillard et al. Twentyeight dermatomes are assessed bilaterally using pinprick and light touch sensation for the sensory score maximum of 112 for pinprick and 112 for. A complete spinal cord injury is defined as the absence of all motor and sensory functions, including sacral roots, distal to the site of injury. An international data sets has been developed based on asia scores to allow.
Injuries to the spinal cord can cause permanent changes to sensations, strength, and bodily functions. The definition is a little confusing because it is also a definition by omission. Asia international standards for neurological classification of spinal cord injury consists of 1 5 category asia impairment scale ais ae, 2 motor score and 3 sensory score asia 2002. American spinal cord injury association asia impairment scale. May, 2019 the extent of spinal cord injury sci is defined by the american spinal injury association asia impairment scale modified from the frankel classification, using the following categories. A spinal cord injury sci is damage to the spinal cord that causes temporary or permanent changes in its function. If voluntary anal contraction noand all s45 sensory scores 0 and any anal sensation no, then injury is complete. American spinal injury association asia impairment scale. The spinal cord after injury a spinal cord injury can occur either from trauma or from a disease. Jan 17, 20 the scim assesses traumatic and nontraumatic, acute and chronic spinal cord injury sci. Standard neurological classification of spinal cord injury motor sensory rl key muscles rl r l c2 c2 c3 c3 c4 c4 c5 elbow flexors c5 c6. An international data sets has been developed based on asia scores to allow international comparisons of levels and types of sci.
The american spinal injury association asia assessment is the international standard for the neurological classification of spinal cord injury. No motor or sensory function in the lowest sacral segment s4s5 sensory function below neurologic level and in s4s5, no motor function below neurologic level. Description and repeatability of a newly developed spinal. A number of tools can be used to assess the outcomes of spinal cord injuries. In 2006, as the result of funding from the national institute on disability and rehabilitation research nidrr, a conference was held as a precourse to the combined annual meetings of the american spinal injury association asia and the international spinal cord society iscos. Depending on the injury location and severity of the damage, an individual can have a complete loss of sensory and motor function or incomplete some function, and tetraplegia all 4 limbs, trunk and pelvic organs or paraplegia trunk, legs and pelvic organs. Spinal cord independence measure rehabmeasures database. The american spinal injury association impairment scale was developed by the american spinal injury association asia in 2006, was revised in 2011, and remains the most widely used neurologic classification of spinal cord injury. Raised by a lawyer and lobbyist who advocated for spinal cord injury survivors, she is a lifelong advocate for spinal injury victims and their loved ones. For example, the higher the level of your injury, the more complications you may face. Dec 02, 2015 american spinal injury association asia impairment scale describes a persons functional impairment as a result of their spinal cord injury. Appendix d tools to assess spinal cord injury outcomes. The objectives of this study were to describe a new spinal cord injury scale for dogs, evaluate repeatability through determining interrater variability of scores, compare these scores to another established system a modified frankel scale, and determine if the modified frankel scale and the newly developed scale were useful as prognostic indicators for return to ambulation.
The asia american spinal injury association assessment protocol consists of two sensory examinations, a motor examination and a classification framework the impairment scale to quantify the severity of the spinal cord injury. Conduction of sensory and motor signals and the autonomic nervous system is affected by spinal cord injury. Answers to your questions, baltimore, md, 1997, paul h brookes publishing company. Level determination, classification, and case examples berrin gunduz istanbul physical medicine rehabilitation training and research hospital, istanbul, turkey abstract performing a standardized physical examination is useful for spinal cord injury patients during followup, monitoring the effects of different. Symptoms may include loss of muscle function, sensation, or autonomic function in the parts of the body served by the spinal cord below the level of the injury. Scientists, clinicians, administrators, individuals with spinal cord injury sci, and caregivers seek a common goal. Jan 18, 20 the asia impairment scale ais classifies motor and sensory impairment that results from a spinal cord injury sci. Spinal cord injury is a mortal condition and has been recognised as such since antiquity.
International standards for the classification of spinal cord injury key sensory points june 2008 c2 at least one cm lateral to the occipital protuberance at the base of the skull. Determine whether the injury is complete or incomplete sacral sparing. Inclusion criteria encompassed class i or ii evidence articles that are in english, human studies, published work, spinal cord injury level of injury above l12, used asia classification for their primary method of neurological assessment to assure uniform patient population, and baseline examination following the injury was from time of admission to the hospital or. Clinical predictors of recovery after blunt spinal cord. No sensory or motor function is preserved in sacral segments s4s5 b incomplete. In subjects with chronic incomplete sci asia d, the extent of atrophy at the c2 level on t1 images is correlated with the asia motor score leftright cord width and with the asia pinprick and light touch scores anteriorposterior cord width, and both motor and sensory measures correlated with spinal cord area. The international standards for neurological classification of spinal cord injury isncsci is an examination used to score the motor and sensory impairment and severity of a spinal cord injury. Comprehensive ability rating scale for the spinal cord lesion patient author.
International standards for neurological classification of. The ais further classifies injuries as a complete or incomplete spinal cord injury. There is much confusion about the american spinal injury association classification of spinal cord injury, also called the asia impairment scale. Introduction spinal cord injury can affect normal breathing. What is asia impairment scale spinal cord injury zone. A spinal cord injury sci is damage to any part of the spinal cord or nerves extending from the spinal cord that often results in permanent changes in motor andor sensory abilities and other. The extent of spinal cord injury sci is defined by the american spinal injury association asia impairment scale modified from the frankel classification, using the following categories. In about 2500 bc, in the edwin smith papyrus, egyptian physician accurately described the clinical features of traumatic tetraplegia quadriplegia and revealed an awareness of the awful prognosis with the chilling advice. Spinal cord injury lifestyle scale scils spinal cord. Good pulmonary care can assist in keeping you healthy after your spinal cord injury. Alternately, it can be located at least 3 cm behind the ear. American spinal injury association asia impairment scale timothy t. C, sensation present, motor present but not useful mrc grade neurologic rehabilitation.