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Arch Phys Med Rehabil. 2012 May;93(5):905-7. doi: 10.1016/j.apmr.2011.10.024. Epub 2012 Feb 22.

Functional motor preservation below the level of injury in subjects with American Spinal Injury Association Impairment Scale grade A spinal cord injuries.

Author information

1
International Collaboration On Repair Discoveries, University of British Columbia, and Vancouver Coastal Health, Vancouver, BC, Canada.

Abstract

OBJECTIVE:

To assess how frequently subjects with spinal cord injuries (SCIs) classified as American Spinal Injury Association Impairment Scale (AIS) grade A have substantial preserved motor function below the neurologic level of injury, despite having no preserved sensory or motor function at the S4-5 spinal cord segment.

DESIGN:

Analysis of the European Multicenter Study about Spinal Cord Injury database to determine how frequently subjects assessed as AIS A would have been AIS D based on motor scores alone (ie, had scores of ≥3 in at least half of the International Standards for Neurological Classification of Spinal Cord Injury [ISNCSCI] key muscles below the neurologic level of injury, despite having no sacral sparing).

SETTING:

Eighteen European centers.

PARTICIPANTS:

Individuals with traumatic SCI at any level (total of 2557 assessments).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURE:

ISNCSCI assessments.

RESULTS:

Over the first year after SCI (with assessments at approximately 1, 4, 12, 24, and 48wk) and for all rostrocaudal levels of injury, only 3.2% of AIS A assessments were found to meet the AIS D motor score criteria. The percentage was highest for lumbar (16.3%) and lower thoracic (4.4%) SCI. No trends were observed across time points.

CONCLUSIONS:

These results suggest that the low frequency of individuals with an AIS A classification and high levels of motor function are not a significant concern in subject recruitment for clinical trials, unless the level of SCI is within the lumbar cord.

PMID:
22360976
DOI:
10.1016/j.apmr.2011.10.024
[Indexed for MEDLINE]

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