American Spinal Injury Association

Muscle strength score[1]
Grade Muscle function
0 No muscle contraction
1 Muscle flickers
2 Full range of motion with gravity eliminated
3 Full range of motion against gravity
4 Full range of motion against resistance
5 Normal strength

The American Spinal Injury Association (ASIA), formed in 1973,[2] publishes the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI),[3] which is a neurological exam widely used to document sensory and motor impairments following spinal cord injury (SCI).[4] The ASIA assessment is the gold standard for assessing SCI.[5] ASIA is one of the affiliated societies of the International Spinal Cord Society.[6]

The exam is based on neurological responses, touch and pinprick sensations tested in each dermatome, and strength of the muscles that control key motions on both sides of the body.[7] Muscle strength is scored on a scale of 0–5 according to the adjacent table, and sensation is graded on a scale of 0–2: 0 is no sensation, 1 is altered or decreased sensation, and 2 is full sensation.[8] Each side of the body is graded independently.[8] When an area is not available (e.g. because of an amputation or cast), it is recorded as "NT", "not testable".[3] The ISNCSCI exam is used for determining the neurological level of injury (the lowest area of full, uninterrupted sensation and function).[3]

The completeness or incompleteness of the injury is measured by the ASIA Impairment Scale (AIS).

ASIA Impairment Scale for classifying spinal cord injury[7][9]
Grade Description
A Complete injury. No motor or sensory function is preserved in the sacral segments S4 or S5.
B Sensory incomplete. Sensory but not motor function is preserved below the level of injury, including the sacral segments.
C Motor incomplete. Motor function is preserved below the level of injury, and more than half of muscles tested below the level of injury have a muscle grade less than 3 (see muscle strength scores table).
D Motor incomplete. Motor function is preserved below the level of injury and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.
E Normal. No motor or sensory deficits, but deficits existed in the past.
  1. ^ Harvey 2008, p. 7.
  2. ^ "ASIA | History". Archived from the original on 2016-01-23. Retrieved 2016-01-05.
  3. ^ a b c Cite error: The named reference KirshblumBurns2011 was invoked but never defined (see the help page).
  4. ^ Cite error: The named reference Marino was invoked but never defined (see the help page).
  5. ^ Dimitrijevic et al. 2012, p. 12.
  6. ^ Affiliated Societies 13.04.2011
  7. ^ a b Cite error: The named reference ISCOS was invoked but never defined (see the help page).
  8. ^ a b Weiss 2010, p. 307.
  9. ^ Teufack, Harrop & Ashwini 2012, p. 67.
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