Model-Based Prediction of Motor Scores From Sensory Scores in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI): Implications on Motor Levels in Segments Without Clinically Testable Key Muscles.

In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), motor levels are inferred from sensory levels for high cervical, thoracic, and low sacral injuries, as key muscles are only assessed in upper and lower extremities. This is known as the "motor follows sen...

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Publicado en:Topics in Spinal Cord Injury Rehabilitation Vol. 31; no. 3; pp. 129 - 140
Autores principales: Schuld, Christian, Gavrilova, Viktoria, Heutehaus, Laura, Maier, Doris, Abel, Rainer, Weidner, Norbert, Rupp, Ruediger, Franz, Steffen
Formato: research tables/charts Journal Article
Publicado: KnowledgeWorks Global, Ltd Summer2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Summer2025
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      pub: KnowledgeWorks Global, Ltd
      place: Richmond, Virginia
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        atl: Model-Based Prediction of Motor Scores From Sensory Scores in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI): Implications on Motor Levels in Segments Without Clinically Testable Key Muscles.
      aug:
        au:
          Schuld, Christian
          Gavrilova, Viktoria
          Heutehaus, Laura
          Maier, Doris
          Abel, Rainer
          Weidner, Norbert
          Rupp, Ruediger
          Franz, Steffen
        affil: Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany
      sug:
        subj:
          Prediction Models
          Motor Activity
          Sensory Motor Integration
          Neurologic Examination Standards
          Spinal Cord Injuries Classification
          Muscles
          Human
          Regression
          Multimethod Studies
          Multiple Linear Regression
          Random Forest
          Comparative Studies
          Machine Learning
          Linear Regression
      ab: In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), motor levels are inferred from sensory levels for high cervical, thoracic, and low sacral injuries, as key muscles are only assessed in upper and lower extremities. This is known as the "motor follows sensory level" rule. To develop regression models for estimating motor scores from sensory scores in segments without clinically testable key muscles and to validate the consensus-based "motor follows sensory level" approach. A total of 6940 ISNCSCI examinations from the European Multicenter Study about Spinal Cord Injury were reviewed. Multiple linear and random forest regression models were trained on scores in clinically testable segments to predict motor from sensory scores of the same spinal segment and side. Models based on ipsilateral light touch or pinprick scores alone, as well as all bilateral sensory scores, were also evaluated. Predicted motor scores were used to recalculate motor levels for the segments without clinically testable key muscles and compared to the true motor levels. The ipsilateral regression models showed minimal differences (R2 0.64-0.65; RMSE 1.34). Normal motor scores were predicted only for normal sensory function; in the linear model, this was captured by the equation: motor score = 0.18 + 1.22 * light touch score + 0.96 * pinprick score. Model-based motor levels were shifted caudally 0.18 segments (linear regression) and 0.32 segments (random forest regression). As models predict normal motor function only for normal sensory scores, predicted motor levels deviate only marginally, supporting the "motor follows sensory level" rule.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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