The asia impairment scale describes a persons functional impairment as a result of their spinal cord injury. A spinal cord injury sci is damage to the spinal cord that causes temporary or permanent changes in its function. 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 level helps to determine future rehabilitation potential and is based on sensory and motor tests ideally performed within the first 72 hours of injury. Elbow flexorsright c4 elbow flexors left wrist extensors c6. Conversion in asia impairment scale during the first year after. Asia impairment scale and spinal cord injuries youtube. Includes asia sci classification approach and complete verses incomplete injuries. The spinal cord is surrounded by rings of bone called vertebrae. Manual for use of walking index for spinal cord injury ii. Motor function is preserved below the neurological level, and more than half of key. The american spinal injury association impairment scale was developed by the american spinal injury association asia in 2006, was revised in 2011, and remains the most widely used neurologic classification of spinal cord injury. The spine consists of a series of vertebral segments. Determine whether the injury is complete or incomplete sacral sparing.
If voluntary anal contraction noand all s45 sensory scores 0 and any anal sensation no, then injury is complete. American spinal injury association asia impairment scale. Conduction of sensory and motor signals and the autonomic nervous system is affected by spinal cord injury. Motor function is preserved below neurologic level and more than half of the key muscle groups below neurologic level have a muscle grade.
There are approximately 12,500 spinal cord injuries in the us annually, with global incidence ranging from 3,000 to 226,000 cases annually. A spinal cord injury sci is damage to any part of the spinal cord or nerves extending from the spinal cord that often results in permanent changes in motor andor sensory abilities and other. Before this, the frankel scale had been developed to categorize spinal cord injuries 3. It identifies sensory and motor levels indicative of the. An international data sets has been developed based on asia scores to allow international comparisons of levels and types of sci. Life expectancy the average remaining years of life for persons with sci have not improved since the 1980s and remain significantly below life expectancies. Asia impairment scale ais is used to grade the severity of a persons neurological impairment following spinal cord injury.
American spinal cord injury association asia impairment. Morganti b, scivoletto g, ditunno p, ditunno jf, molinari m. The premier north american organization in the field of spinal cord injury care, education, and research. Based on the international standards for neurological classification of spinal cord injury isncsci for the impairment scale published by asia.
There are sixteen sets of recommendations corresponding to different types of spinal cord injury, determined by the level of lesion and the score on the asia impairment scale. Spinal cord injury is one of the most common diagnoses in inpatient rehabilitation facilities. Scale assessments can be carried out using this asia impairment scale worksheet pdf. If the injury is complete, asia a it means that no messages can travel across the location. 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. Diagnosis and prognosis of traumatic 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 palm key sensory points s45 s3 s2 s1 l5 l 4 l 3 l 2 c2 c3 c4.
Inclusion criteria encompassed class i or ii evidence articles that are in english, human studies, published work, spinal cord injury level of injury above l12, used asia classification for their primary method of neurological assessment to assure uniform patient population, and baseline examination following the injury was from time of admission to the hospital or. Injury can also be caused by viruses, tumors, or stroke. Dec 23, 2008 the american spinal injury association asia international spinal cord society iscos neurological standard scale ais is currently regarded as the standard measure for neurologic outcomes. 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. Historical life expectancy the average remaining years of life for persons with sci have not improved since the 1980s and remain significantly below life expectancies. Acute traumatic spinal cord injury litfl ccc trauma. The american spinal injury association impairment scale was developed by the american spinal injury association asia in 2006, was revised in 2011, and remains the most widely used neurologic classification of. Sep 17, 2019 asia and iscos international standards committee, asia education committee, rupp r. Traumatic spinal cord injury sci is a serious disorder that has a profound impact on a patients physical and psychosocial wellbeing. 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. Anterior cord syndrome causes complete loss of movement, and pain and temperature loss, but it preserves light touch sensations. Assessor accuracy of the international standards for neurological classification of spinal cord injury isncsci. Spinal cord association asia and international spinal cord society iscos.
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 palm key sensory points s45 s3 s2 s1 l5 l 4 l 3 l 2 c2 c3 c4 t3 t2 t4 t5 t6 t7 t8 t9 t 1 t12 c8 c7 c6 dorsum. Asia impairment scale for spinal injury dr francis deng and assoc prof frank gaillard et al. 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 american spinal injury association impairment scale. Motor function is preserved below the neurological level. 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. After a spinal cord injury, most people recover some function. Asia updateasia impairment scale turkish journal of physical. November 78, 2014 3 asia examination sensory level motor level neurological level of injury nli complete vs. Options treatment of patients with acute spinal cord injuries with gm1. 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. Economic impact of sci published in the journal topics in spinal cord injury rehabilitation, volume 16, number 4, in 2011.
American spinal injury association asia impairment scale timothy t. Asia score and spinal injury classification bone and spine. Injury can occur at any level of the spinal cord and can be complete injury, with a total loss of sensation and muscle. Individuals with spinal cord injuries have significant and permanent impairments that limit their activity level and ability to participate in occupational and social settings. No motor or sensory function is preserved in the sacral segments s4s5. Together, the vertebrae and the membrane make up the spinal column, or backbone. Jun, 2017 this is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. 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 changes have been made to be consistent with the. There are approximately 12,500 spinal cord injuries in the us. Sensory function below neurologic level and in s4s5, no motor function below neurologic level. Spinal cord injury functional ambulation inventory. International standards for neurological classification of spinal cord injury. Motor function is preserved below the neurological level, and more then half of key muscles below the neurological.
The scale has five classification levels, ranging from complete loss of neural function in the affected area to completely normal. The asia scale stands for the american spinal injury association scale and is used to describe the level of a persons spinal cord injury. The american spinal injury association provides downloads for multiple worksheets, guides, brochures and more that may be useful to anyone in the sci field. Aug 07, 2011 traumatic spinal cord injury sci is a serious disorder that has a profound impact on a patients physical and psychosocial wellbeing. The 2019 revision of the international standards for neurological classification of spinal cord injury isncsciwhats new. This is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. In this article, i will briefly address the issue of spinal cord injury levels, the definition of complete spinal cord injury, and the asia classification approach towards spinal cord injury. American spinal cord injury association asia impairment scale. Spinal cord injury types of injury, diagnosis and treatment. Asia impairment scale ais score spinal cord injury. The american spinal injury association international standards for neurological classification of spinal cord injury form used to evaluate spinal cord injury is presented. Functional outcomes following spinal cord injuryvfinal. Asia impairment scale ais in injuries with absent motor or sensory function in s45 only 6. International standards for neurological classification of.
Scis are graded according to the american spinal injury association asia grading scale, which describes the severity of the injury. The anterior spinal cord is the front section of the structure, and the posterior spinal cord is the back. Sensory but not motor function is preserved below the neurological level and includes the sacral segments s4s5. By systematically examining the dermatomes and myotomes, one can determine the cord segments affected by the. The american spinal injury association asiainternational spinal cord society iscos neurological standard scale ais is currently regarded as the. The american spinal injury association impairment scale ais. No clear case of spinal cord injury after direct laryngoscopy in english language literature mcleod and calder criteria all airway maneuvers cause some motion at fracture site lessened with manual in line immobilization increased with increasing instability fiberoptic intubation minimizes displacements. Motor vehicles are the leading cause of injury, and are becoming an increasingly common. Asia impairment scale for spinal injury radiology reference. 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.
Clinical predictors of recovery after blunt spinal cord. In injuries with absent motor or sensory function in s45 only. American spinal injury association impairment scale ais. The recommendations for each type of spinal cord injury includes a brief description of abilities and. The injury can happen by cutting, stretching, or swelling of the spinal cord. The incidence of tsci is estimated to be 11 to 53 new cases per million population. The american spinal injury association asia impairment scale is used to determine the appropriate level of injury and has helped to standardize classification across the country. Assessor accuracy of the international standards for neurological classification of spinal cord. 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.
Standing balance assessment in asia d paraplegic and tetraplegic participants. Elbow flexorsright c4 elbow flexors left wrist extensors. Injury association asia as a universal classification tool for spinal cord injuries. Jun 07, 2016 this is a orthopedic teaching video from orthopedic medical students on trauma or elective orthopedic surgery and relevant topics. Asia and iscos international standards committee, asia education committee, rupp r. Spinal cord injury sci can severely impair or cease the conduction of sensory. Isncsci algorithm calculator to score the asia impairment scale, by the rick hansen institute. Asia impairment scale ais 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.
These syndromes are most common in people with nontraumatic sci as opposed to traumatic sci. Isncsci algorithm calculator to score the asia impairment. 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 asia impairment scale answers spinal cord injury. The american spinal injury association asia assessment is the international standard for the neurological classification of spinal cord injury. It identifies sensory and motor levels indicative of the highest spinal level demonstrating unimpaired function. The backbone, which protects the spinal cord, starts at the base of the skull and ends just above the hips. Nov 18, 2018 the asia scale stands for the american spinal injury association scale and is used to describe the level of a persons spinal cord injury. It is ideally completed within 72 hours after the initial injury. The 2019 revision of the international standards for neurological. All patients with pain along the spine or paresisparalysis should be assumed to have spinal cord injuries until appropriate evaluation can be completed. American spinal injury association asia impairment scale ais. Zone of partial preservation most caudal levels with any innervation sensory motor motor subscores sensory subscores. An international data sets has been developed based on asia scores to allow.
This is based on scores as assessed by the examiner and is popularly called asia score. The neurological severity of a spinal cord injury sci is commonly classified according to the. Incomplete injury sacral sparing zone of partial preservation complete injuries sensory level 28 key dermatomes test light touch and pinprick face is used as control. Asia impairment scale american spinal injury association. These videos have been created by and for our medical students. 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. Spinal cord injury, asia impairment scale, classification. Symptoms and recovery depend on where it happened and how severe it is. 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. What is asia impairment scale spinal cord injury zone.