ASIA Examination

Question 1

Key MM for Motor Level Classification

Answer 1

C5 = elbow flexors (biceps, brachialis)
C6 = Wrist extensors (ECRL and ECRB)
C7 = elbow extensors (triceps)
C8 = Finger flexors to middle fingers (flexor digi profundus)
T1 = small finger abductors (abd digi mini)
L2 = hip flexors
L3 = knee extensors- quads
L4 = ankle DF (tib ant)
L5 = long toe extensors (ext hallucis long)
S1 = ankle PF (gastroc/soleus)

Question 2

ASIA

Answer 2

Define right and left motor levels, right/left sensory levels, neurologic level, and severity of injury (complete/incomplete)

Important information to gather bc can help to predict neuro recovery and level of independence

Question 3

ASIA MM Grading

Answer 3

0 = absence, total paralysis
1 = trace, palpale or visual contraction
2 = poor, active mvmt through full ROM, gravity eliminated
3 = fair, active mvmt full ROM against gravity
4 = good, active full ROM against mod resistance
5 = normal, full AROM against max resistance

Question 4

ASIA defined motor level

Answer 4

the most caudal root level in which mm strength is grade 3 or more and the nest most rostral mm a grade 5

Add mm grades from each side of body to get ASIA motor score

Question 5

ASIA defined Sensory Level

Answer 5

May not correspond directly with motor level
Does not rely on dermatomes, relies on presence of normal light tough and pinprick sensation at key points in each of the 28 dermatomes
proprioception should also be assessed below level of injury in patients with incomplete to determine integrity of the dorsal column

Question 6

ASIA Classification

Answer 6

A = COMPLETE, total absence of motor and sensory function in the lowest sacral segments S4-5
– Zone of partial preservation- term only used with complete injuries, may be some preservation of sensory/motor below level of injury

B = INCOMPLETE, sensory but not motor fxn is preserved below the neurological level and includes sacral segments S4-5

C = INCOMPLETE, motor fxn is preserved below neuro level and more than half of key mm below neuro level have a mm grade less than 3

D = INCOMPLETE, motor fxn is preserved below beuro level and at least half of mm groups below lesion have mm grade of 3 or more

E = NORMAL, motor and sensory fxns are normal

B-D = implies voluntary control of external anal sphincter

Question 7

ASIA Application to Pediatric Pop

Answer 7

ASIA = gold standard for assessing prognosis and outcomes

May have poor utility overall in children 10 and younger d/t poor cooperation (anxiety with pinprick)

May have decreased reliability in younger children

Decreased validity of anorectal exam–specifically when injury occurs prior to child being potty trained, and teens due to privacy concerns

Question 8

Functional Assessment

Answer 8

FIM and WeeFIM- may not be sensitive enough to detect changes

PedsQL and COPM (canadian occupational performance measure)

Spinal Cord Independence Measure (SCIM)- strong construct validity, inter-rater reliability, and sensitivity to change

Important for PT to determine accurate baseline