Van Middendorp et al developed a clinical prediction rule for ambulation following traumatic spinal cord injury. The authors are from Radboud University Nijmegen Medical Centre in the Netherlands, Thomas Jefferson University in Philadelphia, and Balgrist University in Zurich.
Parameters:
(1) age
(2) motor score at L3 = knee extensors = quadriceps (better of left or right side)
(3) motor score at S1 = ankle plantar flexors = soleus, gastrocnemius (better of left or right side)
(4) light touch score at L3 (better of left or right side)
(5) light touch score for S1 (better of left or right side)
|
Parameter |
Finding |
Points |
|
age |
< 65 years |
0 |
|
|
>= 65 years |
-10 |
|
motor score L3 |
normal |
10 |
|
|
active movement against gravity and resistance |
8 |
|
|
activement movement against gravity |
6 |
|
|
active movement with gravity eliminated |
4 |
|
|
flicker or trace of muscle contractions |
2 |
|
|
no muscle contractions |
0 |
|
motor score S1 |
normal |
10 |
|
|
active movement against gravity and resistance |
8 |
|
|
activement movement against gravity |
6 |
|
|
active movement with gravity eliminated |
4 |
|
|
flicker or trace of muscle contractions |
2 |
|
|
no muscle contractions |
0 |
|
light touch at L3 |
normal |
10 |
|
|
impaired |
5 |
|
|
absent |
0 |
|
light touch at S1 |
normal |
10 |
|
|
impaired |
5 |
|
|
absent |
0 |
where:
• The points assigned are based on a test score multiplied by a weighted coefficient. The coefficients were -10 for age, 2 for motor scores and 5 for sensory.
• Motor scores are based on the MRC grading scale in Chapter 20.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: -10
• maximum score: 40
• The higher the score the greater the probability of being able to walk independently.
X = (0.267 * (score)) - 3.273
probability of walking independently =
= 1 / (1 + EXP((-1) * X))
Purpose: To determine the chance of a patient with traumatic spinal cord injury being to walk independently using the prediction rule of van Middendorp et al.
Specialty: Sports Medicine & Rehabilitation
Objective: severity, prognosis, stage, disability and performance
ICD-10: T09.3,
