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Review
. 2010;33(4):346-52.
doi: 10.1080/10790268.2010.11689712.

_ 2009 review and revisions of the international standards for the neurological classification of spinal cord injury

William P Waring 3rd  1 , Fin Biering-Sorensen, Stephen Burns, William Donovan, Daniel Graves, Amitabh Jha, Linda Jones, Steven Kirshblum, Ralph Marino, M J Mulcahey, Ronald Reeves, William M Scelza, Mary Schmidt-Read, Adam Stein
Affiliations
Review

_ 2009 review and revisions of the international standards for the neurological classification of spinal cord injury

William P Waring 3rd et al. J Spinal Cord Med. 2010.

Abstract

The International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) were recently reviewed by the ASIA's Education and Standards Committees, in collaboration with the International Spinal Cord Society's Education Committee. Available educational materials for the ISNCSCI were also reviewed. The last citable reference for the ISNCSCI's methodology is the ISNCSCI Reference Manual, published in 2003 by ASIA. The Standards Committee recommended that the numerous items that were revised should be published and a precedent established for a routine published review of the ISNCSCI. The Standards Committee also noted that, although the 2008 reprint pocket booklet is current, the reference manual should be revised after proposals to modify/revise the ASIA Impairment Scale (AIS as modified from Frankel) are considered. In addition, the Standards Committee adopted a process for thorough and transparent review of requests to revise the ISNCSCI.

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Figures

Figure 1
Figure 1
C6—wrist extension, grades 4–5. Resistance is given by grasping the hand and applying force in a diagonally down and out (flexion and ulnar deviation) motion.
Figure 2
Figure 2
C8—finger flexors (distal phalanx of middle finger). Stabilize the proximal interphalangeal and metacarpophalangeal to prevent substitution.
Figure 3
Figure 3
L3—knee extensors, grades 4–5. 30 degrees of knee flexion allows the examiner to place one arm underneath the knee to be tested and on top of the opposite knee to allow better leverage for the examiner when testing for strength.
Figure 4
Figure 4
ASIA Impairment Scale grade worksheet. Refer to bottom row of data for the N-O-O-O-O-N sign if the injury is complete.
See this image and copyright information in PMC

References

    1. American Spinal Injury Association. Reference Manual for the International Standards for Neurological Classification of Spinal Cord Injury. Chicago, IL: American Spinal Injury Association; 2003.
    1. American Spinal Injury Association/International Medical Society of Paraplegia. International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients (Revised) Chicago, IL: American Spinal Injury Association; 1992.
    1. American Spinal Injury Association/International Medical Society of Paraplegia. International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients. Chicago, IL: American Spinal Injury Association; 1996.
    1. American Spinal Injury Association/International Medical Society of Paraplegia. International Standards for Neurological and Functional Classification of Spinal Cord Injury Patients. Chicago, IL: American Spinal Injury Association; 2000.
    1. American Spinal Injury Association. Reference Manual for the International Standards for the Classification of Spinal Cord Injury. Chicago, IL: American Spinal Injury Association; 1994.

MeSH terms