What is the ASIA Impairment Scale for spinal injuries?
The ASIA Impairment Scale is another helpful guide to understanding an injury. It was developed by doctors at the American Spinal Injury Association (ASIA) to categorize the extent of an injury in terms of the degree of damage to the spinal cord.
What is the Asia test for spinal cord injury?
Testing Spinal Cord Injuries: The ASIA Exam An American Spinal Injury Association (ASIA) exam is a standard physical to help: Determine which parts of the body are working normally and which parts are affected by the spinal cord injury. Classify the level of your spinal cord injury.
What kind of testing is done for spinal cord injuries?
Testing Spinal Cord Injuries: The ASIA Exam. An American Spinal Injury Association (ASIA) exam is a standard physical to help: Determine which parts of the body are working normally and which parts are affected by the spinal cord injury. Classify the level of your spinal cord injury. Predict your recovery from the injury.
What are the most common physiotherapy activities in individuals with AIS D?
Gait training, strengthening, and balance exercises were the most common physiotherapy activities in individuals with an AIS D spinal cord injury. Overall strengthening was the most common group therapy activity across all levels and types of spinal cord injury.
WHAT IS ASIA Impairment Scale A?
Grade A: The impairment is complete. There is no motor or sensory function left below the level of injury. Grade B: The impairment is incomplete.
What is the Asia spinal cord injury Scale?
The American Spinal Injury Association (ASIA) impairment scale or AIS describes a person's functional impairment as a result of a SCI. This scale indicates how much sensation a person feels after light touch and a pin prick at multiple points on the body and tests key motions on both sides of the body.
Can you recover from ASIA A?
About 20% of ASIA A (complete SCI) patients experience some level of spontaneous recovery within the first year. Between 15 and 40% of patients with initial ASIA B scores converted to ASIA C or D status, and 60 to 80% of patients with initial ASIA C scores converted to ASIA D status.
What is a grade A spinal cord injury?
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. These injuries are designated as being Grade A on the AIS.
How does the ASIA scale work?
The ASIA Impairment Scale assigns the SCI a grade based on its severity. Grades range from A to E, with A being the most severe injury and E being the least severe.
What is the Asia test?
This is a system of tests used to define and describe the extent and severity of a patient's spinal cord injury and help determine future rehabilitation and recovery needs. It is ideally completed within 72 hours after the initial injury.
What is the best treatment for spinal cord injury?
Options include soft neck collars and various braces. Surgery. Often surgery is necessary to remove fragments of bones, foreign objects, herniated disks or fractured vertebrae that appear to be compressing the spine. Surgery might also be needed to stabilize the spine to prevent future pain or deformity.
Can you walk again after spinal compression?
There is potential to walk again after SCI because the spinal cord has the ability to reorganize itself and make adaptive changes called neuroplasticity. With an effective rehabilitation plan and consistency, individuals may be able to promote neuroplasticity to optimize their mobility.
What is Asia a paraplegia?
The ASIA Impairment Scale is follows the Frankel scale but differs from the older scale in several important respects. First, instead of no function below the injury level, ASIA A is defined as a person with no motor or sensory function preserved in the sacral segments S4-S5.
What are the three types of spinal cord injuries?
There are three types of complete spinal cord injuries:Tetraplegia.Paraplegia.Triplegia.
What is considered a severe spinal cord injury?
Cervical spinal cord injuries affect the head and neck region above the shoulders. It is the most severe level of spinal cord injury.
Which scale is most commonly used to classify the severity of spinal cord injury?
The most commonly used scale for measuring spinal cord injury is the American Spinal Injury Association (ASIA) impairment scale. This scale breaks down the severity of the injury into five categories labeled A through E.
How long does SCI rehab last?
The acute management and rehabilitation of SCI depend on the level and type of injury to the spinal cord. Individuals with a SCI often require initial treatment in an intensive care unit with the rehabilitation process typically starting in the acute care setting, followed by extended treatment in a specialised Spinal Injury Unit. Inpatient management can last from 8 - 24 weeks, with follow up outpatient rehabilitation from 3 - 12 months, generally followed by yearly medical and functional reviews.
What is the difference between SCI and tetraplegia?
SCI, most commonly, results in paraplegia or tetraplegia. Paraplegia is the loss in motor and/ or sensory function in the lower limbs (LLs) and trunk. While tetraplegia includes the upper limbs (ULs) to the motor and/ or sensory loss of the LLs and trunk .
What is spinal cord injury?
Spinal Cord Injuries (SCI) can be defined as a traumatic or non-traumatic event that leads to neural damage that influences motor-, sensory - and respiratory function, as well as bladder -, bowel - and sexual function. The neurological interruption also affects the individual's blood pressure, skin integrity and ability to regulate temperature.
What are the secondary complications of SCI?
Respiratory Function. Common secondary complications include hypoventilation, atelectasis, secretion retention and pneumonia. The respiratory function is affected due to disruption in the spinal cord relevant to the neurological level of the SCI.
Can you live independently with a spinal cord injury?
Individuals with a spinal cord injury, depending on the level and type of lesion, may have many complex needs and face wide-ranging, long-term restrictions in their ability to live independently, drive or use public transport, return to work or education, participate in leisure and social activities.
Contact Us
Call 1-877-AT-REHAB (28-73422) to learn more about our spinal cord injury rehabilitation program or to refer a patient.
Sensory Exam
There are two parts of the sensory exam: light touch and pinprick. Light touch and pinprick are tested separately because they travel in different nerve pathways in the spinal cord.
Outpatient Care
To make an appointment in the outpatient spinal cord injury clinic at UPMC Mercy, please call 412-232-8901.
What is the purpose of a spinal cord exam?
An accurate clinical examination of a person with a spinal cord injury is a medical and legal diagnosis, predicts recovery, frames rehabilitation and health care, and is essential for research.
What is Instep course?
The International Standards Training e-Learning Program, or InSTeP, is a five-module course designed to enable clinicians to perform accurate and consistent neurological examinations of individuals with spinal cord injury.
What is the contribution of Asia?
One of the major contributions of ASIA has been the development of the International Standards for the Neurological Classification of Spinal Cord Injuries (the Standards). The Standards are the accepted gold standard…
How many levels below motor level should AIS B be tested?
In a patient with an apparent AIS B classification, non-key muscle functions more than 3 levels below the motor level on each side should be tested to most accurately classify the injury (differentiate between AIS B and C).
When to use AIS E?
Note: AIS E is used in follow-up testing when an individual with a documented SCI has recovered normal function. If at initial testing no deficits are found, the individual is neurologically intact and the ASIA Impairment Scale does not apply.
Introduction
Sensory Examination
- Key Sensory Points are readily located in relation to bony anatomical landmarks in the dermatomesC2 - S5. They are tested bilaterally using Light Touch (LT) and Pin-Prick (PP) [sharp-dull discrimination]. Equipment common to clinical settings are used, such as a cotton tip applicator for light touch and either a neuro-tip or safety pin for pin-prick. Appreciation of light to…
Motor Examination
- Key Motor Functions of the 10 Paired MyotomesC5 - T1 and L2 - S1 are tested bilaterally. Improper positioning and stabilization can lead to substitution by other muscles, and will not accurately reflect the muscle function being graded. A Six-Point Scale is used for scoring: Patient should be supine-lying for testing, except for the rectal examination that can be performed side-l…
Determination of Neurological Level of Injury
- The Neurological Level of Injury is determined by identifying the most caudal segment of the cord with intact sensation and antigravity muscle function strength (Grade 3 or more) on both sides of the body, provided that there is normal, intact sensory and motor function rostrally (Grade 5). Sensory Level refers to the most caudal, intact dermatome for both light touch and pin-prick sen…
Asia Impairment Scale
- Spinal Cord Injuries are classified in general terms of being neurologically “Complete” or “Incomplete” based upon Sacral Sparing, which refers to the presence of Sensory or Motor Function in the most Caudal Sacral Segments i.e. preservation of light touch or pin prick sensation at S4-5 Dermatome, Deep Anal Pressure or Voluntary Anal Sphincter Contraction. The following …
Zone of Partial Preservation
- Earlier, the Zone of Partial Preservation (ZPP) was only used with Complete Injuries ASIA Impairment Scale - Grade A (AIS A). With the 2019 revision, the ZPP now applies to all cases regardless of the grades of AIS.ZPP refers to the dermatomes and myotomes caudal to the sensory or motor level that remain partially innervated. The extent of the Sensory or Motor ZPP i…
Psychometrics
- Reliability
The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Sensory and Motor examinations are reliable when conducted by a trained examiner. Both interrater and intrarater reliability were found to be excellent. Formal training in the administratio… - Validity
The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) are validated for injury classification.Construct validity of the ASIA Motor Score as a measure of recovery following spinal cord injury and as an outcome measure for clinical trials is greater whe…
Resources
- International Standards for Neurological Classification of Spinal Cord Injury: Assessment Forms 1. ASIA Impairment Scale: International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) Assessment Form 2. ASIA Impairment Scale: Autonomic Standards Assessment Form International Standards for Neurological Classification of Spinal Cord Injury: Sensory and …
Introduction
Physiotherapy Management
- The acute management and rehabilitation of SCI depend on the level and type of injury to the spinal cord. Individuals with an SCI often require initial treatment in an intensive care unit with the rehabilitation process typically starting in the acute care setting, followed by extended treatment in a specialised Spinal Injury Unit. Inpatient manage...
Acute Phase
- The prevention of complications arising from spinal instability or neurological compromise involves all members of the multi-disciplinary team. In this early phase post-injury, physiotherapy management is predominantly involved in the prevention and management of respiratory and circulatory complications, as well as minimising the impact of immobilization on the individual e…
Sub-Acute (Rehabilitation) Phase
- The rehabilitation needs of individuals with an SCI are best at a specialised Spinal Cord Injury Unit, but often rehabilitation begins in the Acute or Trauma Hospital while the individual is awaiting transfer to a Spinal Injuries Unit. Rehabilitation requires consideration of the whole person; their physical, psychological, vocational and social background. The rehabilitation process is a goal-d…
Long Term Phase
- Individuals with a spinal cord injury, depending on the level and type of lesion, may have many complex needs and face wide-ranging, long-term restrictions in their ability to live independently, drive or use public transport, return to work or education, participate in leisure and social activities. To ensure successful long term management coordinated community rehabilitation s…