The American Spinal Injury Association (ASIA) and International Medical Society of Paraplegia have developed a standard form for capturing clinical information when evaluating a patient who has had a spinal cord injury.
Assessments:
(1) motor function
(2) sensory function
(3) additional questions
Motor Function
|
Muscle Tested (left and right sides tested separately) |
Spinal Level |
|---|---|
|
elbow flexors |
C5 |
|
wrist extensors |
C6 |
|
elbow extensors |
C7 |
|
finger flexors (distal phalanx of the middle finger) |
C8 |
|
finger abductors (little finger) |
T1 |
|
Muscle Tested (left and right sides tested separately) |
Spinal Level |
|---|---|
|
hip flexors |
L2 |
|
knee extensors |
L3 |
|
ankle dorsiflexors |
L4 |
|
long toe extensors |
L5 |
|
ankle plantar flexors |
S1 |
|
Scoring Motor Function |
Points |
|---|---|
|
total paralysis |
0 |
|
palpable or visible contraction |
1 |
|
active movement, eliminated by gravity |
2 |
|
active movement against gravity |
3 |
|
active movement against some resistance |
4 |
|
active movement against full resistance |
5 |
|
not tested |
NT |
Sensory Function
Sensory Tests at 28 levels, bilateral:
(1) light touch
(2) pin prick
|
Sensory Tests (left and right sides tested separately) |
Spinal Level |
|---|---|
|
occipital protuberance |
C2 |
|
supraclavicular fossa |
C3 |
|
top of the acromioclavicular joint |
C4 |
|
lateral side of the antecubital fossa |
C5 |
|
thumb |
C6 |
|
middle finger |
C7 |
|
little finger |
C8 |
|
ulnar (medial) side of the antecubital fossa |
T1 |
|
apex of the axilla |
T2 |
|
third intercostal space |
T3 |
|
fourth intercostal space (nipple line) |
T4 |
|
fifth intercostal space (midway between T-4 and T-6) |
T5 |
|
sixth intercostal space (level of the xiphisternum) |
T6 |
|
seventh intercostal space (midway between T-6 and T-8) |
T7 |
|
eighth intercostal space (midway between T-6 and T-10) |
T8 |
|
ninth intercostal space (midway between T-8 and T-10) |
T9 |
|
tenth intercostal space (umbilicus) |
T10 |
|
eleventh intercostal space (midway between T-10 and T12) |
T11 |
|
inguinal ligament at the midpoint |
T12 |
|
half the distance between T-12 and L-2 |
L1 |
|
midanterior thigh |
L2 |
|
medial femoral condyle |
L3 |
|
medial malleolus |
L4 |
|
dorsum of the foot at the 3rd metatarsophalangeal joint |
L5 |
|
lateral heel |
S1 |
|
popliteal fossa in the midline |
S2 |
|
ischial tuberosity |
S3 |
|
perianal area |
S4-S5 |
from Maynard
|
Grading Sensory Function |
Points |
|---|---|
|
absent |
0 |
|
impaired |
1 |
|
normal |
2 |
|
not tested |
NT |
Additional Questions
Presence or absence of
(1) voluntary anal contractions seen or felt (motor)
(2) any anal sensation (sensory)
If any sensory or motor function seen in the lowest sacral segment, then incomplete.
If no sensory and no motor function seen in the lowest sacral segment, then complete.
|
Segment |
Neurologic Status |
Side |
|---|---|---|
|
most caudal |
normal motor function |
left |
|
most caudal |
normal motor function |
right |
|
most caudal |
normal sensory function |
left |
|
most caudal |
normal sensory function |
right |
|
any |
partial preservation of motor function |
left |
|
any |
partial preservation of motor function |
right |
|
any |
partial preservation of sensory function |
left |
|
any |
partial preservation of sensory function |
right |
|
highest |
no motor function |
left |
|
highest |
no motor function |
right |
|
highest |
no sensory function |
left |
|
highest |
no sensory function |
right |
Interpretation:
• minimum motor score on each side: 0
• minimum total motor score: 0
• maximum total motor score on each side: 50
• maximum total motor score: 100
• minimum total light touch score on each side: 0
• minimum total light touch score: 0
• maximum total light touch score on each side: 56
• maximum total light touch score: 112
• minimum total pin prick score on each side: 0
• minimum total pin prick score: 0
• maximum total pin prick score on each side: 56
• maximum total pin prick score: 112
Specialty: Neurology
