With suspected spinal cord or vertebral injury, the patient should be immediately immobilized as an estimated 3 to 25% of injuries to the spinal cord occur during transport or resuscitation. The asia scale stands for the american spinal injury association scale and is used to describe the level of a persons spinal cord injury. Outcome can be looked at from three different domains. 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. Isncsci algorithm calculator to score the asia impairment. American spinal injury association impairment scale ais. The spinal cord is surrounded by rings of bone called vertebrae. The american spinal injury association impairment scale is a standardized neurological examination used by the rehabilitation team to assess the sensory and motor levels which were affected by the spinal cord injury.
The purpose of this report is to summarize the asia impairment scale, a part of the international standards for neurological classification of spinal cord injury, and summarize leveling and grading with examples. Includes asia sci classification approach and complete verses incomplete injuries. International standards for neurological classification of spinal cord injury. Classification of spinal cord injury isncsci patient name datetime of exam examiner name signature international standards for neurological c2 c3 c4 c6 t1 c5 l1 l2 l3 l4 l5. The large majority of individuals with complete spinal cord injuries as defined by the american spinal injury association asia impairment scale see figure 612 will need to rely on purely compensatory techniques to achieve even minimal levels of ambulation. The neurological severity of a spinal cord injury sci is commonly classified according to the american spinal injury association asia impairment scale ais.
Isncsci examiner name signature right left key muscles. American spinal cord injury association asia impairment scale. Short communication walking index for spinal cord injury. Elbow flexorsright c4 elbow flexors left wrist extensors. A complete spinal cord injury is an absence of motor or sensory function in the area around the anus. Anterior cord syndrome causes complete loss of movement, and pain and temperature loss, but it preserves light touch sensations.
Asia impairment scale american spinal injury association. The american spinal injury association asiainternational spinal cord society iscos neurological standard scale ais is currently regarded as the. The incidence of tsci is estimated to be 11 to 53 new cases per million population. 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. Motor function is preserved below the neurological level, and more then half of key muscles below the neurological.
Asia standards 1982 revision 1989 asia impairment scale 1992 revisions 1996 revisions 2000 reprinting in 2002, 2006, 2008 revisions june 2011 7th edition of the international standards for neurological classification of spinal cord injury isncsci june 2011 revisions asia international standards 2011. It was originally developed by the american spinal injury association asia and is. Abstractthe spinal cord independence measure scim is, at present, the only comprehensive rating scale that measures the ability of patients with spinal cord lesions scl to perform everyday tasks according to their va lue for the patient. The shoulder is in neutral rotation, neutral flexionextension, and neutral abadduction. Isncsci algorithm calculator to score the asia impairment scale, by the rick hansen institute. Spinal cord injury functional ambulation inventory. An international data sets has been developed based on asia scores to allow.
The backbone, which protects the spinal cord, starts at the base of the skull and ends just above the hips. There are approximately 12,500 spinal cord injuries in the us annually. This article describes the scale and its scoring techniques, presents the purposes for which scim is used, and details its advantages for patients with scl. The 2019 revision of the international standards for neurological classification of spinal cord injury isncsci was released at asia s honolulu meeting in spring, 2019. The cost associated with spinal cord injuries is substantial, with estimates of the average lifetime cost of direct care ranging from usd 1. Asia impairment scale free download as powerpoint presentation. Sensory but not motor function is preserved below the neurological level and includes the sacral segments s4s5. The american spinal injury association asia assessment is the international standard for the neurological classification of spinal cord injury. Options treatment of patients with acute spinal cord injuries with gm1. International standards for neurological classification of. The asia level helps to determine future rehabilitation potential and is based on sensory and motor tests ideally performed within the first 72 hours of injury. It identifies sensory and motor levels indicative of the. Its founders sought to establish a standardized model of care for the growing number of patients with spinal cord injuries.
The international standards for neurological classification of spinal cord injury isncsci. Functional outcomes following spinal cord injuryvfinal. Motor function is preserved below neurologic level and more than half of. The subcommittee considered that a better option for defining incomplete spinal cord injuries in the new zealand environment would be to use the american spinal injury association asia standard neurological classification of spinal cord. Pdf asia impairment scale conversion in traumatic sci. Before this, the frankel scale had been developed to categorize spinal cord injuries 3.
The american spinal injury association impairment scale. Asia impairment scale ais is used to grade the severity of a persons neurological impairment following spinal cord injury. Asia impairment scale ais score spinal cord injury. Assessor accuracy of the international standards for neurological classification of spinal cord. The asia impairment scale describes a persons functional impairment as a result of their spinal cord injury. The scale has five classification levels, ranging from complete loss of neural function in the affected area to completely normal. The anterior spinal cord is the front section of the structure, and the posterior spinal cord is the back. It identifies sensory and motor levels indicative of the highest spinal level demonstrating unimpaired function. No motor or sensory function is preserved in the sacral segments s4s5. 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. The aim of this study was to assess the course of the ais following sci, and to discern the nature of any changes in the classification that occur.
However, the frankel scale had considerable limitations. The asia impairment scale is another helpful guide to understanding an injury, it was developed by doctors at the american spinal injury association. Traumatic spinal cord injury sci is a serious disorder that has a profound impact on a patients physical and psychosocial wellbeing. Spinal cord 2001 39, 654656 introduction a walking scale for use in multicenter trials was recently published and documented face validity, concurrent validity, and interrater reliability. All patients with pain along the spine or paresisparalysis should be assumed to have spinal cord injuries until appropriate evaluation can be completed. Motor vehicles are the leading cause of injury, and are becoming an increasingly common. Spinal cord injury, asia impairment scale, classification. Motor function is preserved below the neurological level, and more than half of key. It is ideally completed within 72 hours after the initial injury.
The international standards for neurological classification of spinal cord injury isncsci, commonly referred to as the asia exam, was developed by the. The international standards for neurological classification of spinal cord injury isncsci or more commonly referred to as the asia impairment scale ais, was developed by the american spinal injury association asia as a universal classification tool for spinal cord injury based on a standardized sensory and motor assessment, with the most recent revised edition published in 2011. The asia american spinal injury association impairment scale ais, based on the frankel scale, is a clinicianadministered scale used to classify the severity completeness of injury in individuals with sci. Associationinternational spinal cord society asiaiscos neurological standard scale ais outcome. Asia updateasia impairment scale turkish journal of physical. Economic impact of sci published in the journal topics in spinal cord injury rehabilitation, volume 16, number 4, in 2011. The terminology of spinal cord injury levels, severity, and classification. The asia impairment scale classifies motor and sensory impairment that results from a 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. American spinal injury association asia impairment scale. Based on the international standards for neurological classification of spinal cord injury isncsci for the impairment scale published by asia. American spinal injury association impairment scale an. It divides spinal cord injuries into 5 categories, ae, with optional clinical syndromes. Muscle function grading asia impairment scale ais steps in classification sensory grading when to test nonkey muscles.
International standards for the classification of spinal. Clinical predictors of recovery after blunt spinal cord. Zone of partial preservation most caudal levels with any innervation. 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. Together, the vertebrae and the membrane make up the spinal column, or backbone. Manual for use of walking index for spinal cord injury ii.
There are approximately 12,500 spinal cord injuries in the us annually, with global incidence ranging from 3,000 to 226,000 cases annually. Asia and iscos international standards committee, asia education committee, rupp r. This is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. Conversion in asia impairment scale during the first year. This is an asia a classification on the asia impairment scale. Instructions for the use of the walking index for spinal cord injury ii wisci ii march 2005 scoring see attached scoring sheet the walking index for spinal cord injury scale wisci 2 has demonstrated a response to change in the spinal cord injury locomotion trial. Asia impairment scale1992 fim incorporated, pplt tested separately, motor level defined as 35 with 55 above. The forearm is in full pronation and the wrist in neutral.
This is a system of tests used to define and describe the extent and severity of a patients spinal cord injury and help determine future rehabilitation and recovery needs. Spinal cord association asia and international spinal cord society iscos. Asia impairment scale and spinal cord injuries youtube. S1s3 asia assessment of spinal cord injuryhistory r. Standing balance assessment in asia d paraplegic and tetraplegic participants. Asia impairment scale ais in injuries with absent motor or sensory function in s45 only 6. Diagnosis and prognosis of traumatic spinal cord injury. Comprehensive ability rating scale for the spinal cord lesion patient author. These syndromes are most common in people with nontraumatic sci as opposed to traumatic sci.
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