Neuro Trauma Motor Index (TMI)

 

Muscles tested for left and right sided motor function:

(1) deltoid (C5)

(2) biceps (C5)

(3) triceps (C7)

(4) flexor digitorum (C7)

(5) abductor digiti minimi (T1)

(6) iliopsoas (L1-L2)

(7) quadriceps femoris (L3)

(8) extensor digiti (L5-S1)

(9) gastrocnemius (S1)

 

Motor Function (for left or right muscles)	Grade
absent; total paralysis	0
trace; palpable or visible contraction	1
poor; active movement through the range of motion with gravity eliminated	2
fair; active movement through range of motion against gravity	3
good; active movement through range of motion against resistance	4
normal	5

 

Muscles tested as without respect to side:

(1) diaphragm

(2) intercostals

(3) upper abdominals

(4) lower abdominals

(5) anal

 

Motor Function (for non-sided muscles)	Grade
absent; total paralysis	0
weak	1
normal	2

 

trauma motor index =

= SUM(points for all groups tested)

 

Interpretation:

• minimum index: 0

• maximum index: 100

• The higher the score, the greater the motor function that is present.

• The greater the initial motor index, the greater the motor function recovery (see Figure 2, page 156, Lucas and Ducker)

 

Modified TMI

 

Bondurant et al use a modified TMI:

(1) does not include non-sided muscles (diaphragm, abdominals, etc.)

(2) slightly different selection of muscles, giving a better measure of spinal level

 

Muscles selected, bilateral (maximum score each side 50 points)

(1) deltoid and/or biceps (C5)

(2) wrist extensors (C6)

(3) triceps (C7)

(4) flexor profundus (C8)

(5) hand intrinsics (T1)

(6) iliopsoas (L2)

(7) quadriceps (L3)

(8) tibialis anterior (L4)

(9) extensor hallucis longus (L5)

(10) gastrocnemius (S1)