2. They identify sensory and motor levels indicative of the lowest spinal levels demonstrating “unimpaired” function.
2. The results are summed to produce overall sensory and motor scores and are used in combination with evaluation of anal sensory and motor function as a basis for the determination of the ASIA Impairment Scale (AIS).
2. The presence of anal sensation and voluntary anal contraction are assessed as a yes or no.
3. Bilateral motor and sensory levels and the AIS are based on the results of these examinations.
4. A more accurate representation of motor function has been demonstrated when overall ASIA motor scores are divided into separate upper and lower limb scores.
2. ASIA motor scores collected early following injury have some predictive validity in explaining functional outcomes.
Interpretability– The AIS scores are clearly defined and understood by most clinicians. The AIS (5 point ordinal scale) classifies individuals from “A” (complete SCI) to “E” (normal sensory and motor function). Preservation of function in the sacral segments (S4-S5) is key for determining the AIS.
Acceptability – The assessment is generally well tolerated although sensory testing can be a problem with severe hypersensitivity, and testing for voluntary anal contraction can result in the stimulation of a bowel movement.
Feasibility – Takes approximately 20 minutes to conduct/score. Training is mandatory and no specialized equipment is required.
Table 1. ASIA Psychometric Summary
|+++||TR ++||++||Construct +++||N/A||N/A||N/A|
Note: +++ = Excellent; ++ = Adequate; + = Poor; N/A=Insufficient information; TR=Test re-test
For more information, please see: American Spinal Injury Association: International Standards for Neurological Classification of Spinal Cord Injury.