ASIA Impairment Scale- SCI Flashcards
What is the AIS impairment scale?
Standardized examination
- myotome- based motor exam
- dermatome based sensory exam
- anorectal exam
Allows for more accurate, reproducible classifications of motor and sensory loss of SCI
Allow for accurate characterization of complete vs incomplete lesions
AIS has been revised multiple times to improve its accuracy and reproducibility
What is the sensory level testing?
28 key dermatomes
- LT= light touch
- PP= pin prick
Right and left side tested
Face is the control
S4/ S5 is perianal area
Deep anal pressure (absent or weak)
Lowest level is where score is 2 with all levels above also 2s
What is motor level testing?
10 key muscle group tested
Tested Rostral to caudal (head to toe)
6 point scale (pluses or minus)
Voluntary anal contraction (Present or absent)
Score right and left sides
Level is strength at least 3/5 with 5/5 for all levels above
What is neurological level of injury (NLI)?
Most caudal (lowest) segment of SC with normal sensory and motor function bilaterally
- motor greater than 3/5 (all levels above 5/5)
- sensory intact bilaterally (LT and PP) with all levels above 2
Can record each side separately
What is complete vs incomplete?
Complete = no sacral sparing
Incomplete = any sacral sparing
Sacral sparing
Spinal shock resolution
Some of partial preservation
What is sacral sparing?
Voluntary anal sphincter contraction
Perinanal sensory function (LT or PP to S4/5)
Anal sensation- deep anal pressure
What is the zone of partial preservation?
Applies to complete injuries (Asia A)
Refers to dermatomes and myotomes casual to sensory and motor levels that remain partially innervated
What is spinal shock?
Temporary loss or depression if all or most spinal reflex activity below the level of injury
- flaccid motor paralysis
- loss of sensory function
- loss of deep tendon reflexes
Hypotension may be present
Usually temporary
NOT the same as neurogenic shock
Clinical features
- flaccid areflexic paralysis
- absent bulbocavernosus reflex
Resolution occurs over a period of days to months
What is the timing of assessment?
Often performed in ER directly after trauma
72hrs may be better for prognosis prediction
Prognosis important for planning rehab and predicting functional recovery
What is the recovery pattern of SCI?
Strong relationship b/n functional status and complete vs incomplete injury
Status may be unclear until after resolution of spinal shock
ASIA scale can be used as input: short and long term functional goals
