Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes.
In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), two approaches for determining motor levels (MLs) in not clinically testable myotomes (C2-C4, T2-L1, S2-S5) are described: one where the motor level follows the sensory level (MFSL) and another deriving m...
| Publicado en: | Topics in Spinal Cord Injury Rehabilitation Vol. 31; no. 3; pp. 37 - 48 |
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| Autores principales: | , , , , , , , , |
| Formato: | pictorial research tables/charts Journal Article |
| Publicado: |
KnowledgeWorks Global, Ltd
Summer2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=187499933&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 187499933 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10820744 0OF jtl: Topics in Spinal Cord Injury Rehabilitation issn: 10820744 maglogo: N pubinfo: dt: Summer2025 vid: 31 iid: 3 pid: 81084 pub: KnowledgeWorks Global, Ltd place: Richmond, Virginia artinfo: ui: 187499933 187499933 187499933 10.46292/sci24-00094 187499933 ppf: 37 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes. aug: au: Schuld, Christian Franz, Steffen Heutehaus, Laura Walden, Kristen Rodriguez, Gianna Guest, James Biering-Sørensen, Fin Kirshblum, Steven Rupp, Ruediger affil: Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany sug: subj: Spinal Cord Injuries Classification Neurologic Examination Standards Spinal Cord Injuries Organizations Medical Organizations Muscle, Skeletal Physiopathology Human Multicenter Studies Data Analytics Wilcoxon Signed Rank Test Confidence Intervals Program Implementation Descriptive Statistics ab: In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), two approaches for determining motor levels (MLs) in not clinically testable myotomes (C2-C4, T2-L1, S2-S5) are described: one where the motor level follows the sensory level (MFSL) and another deriving motor function from sensory function (MFSF). Their results differ when (1) all key muscles of an upper (or upper and lower) extremity are scored as intact, (2) sensation is not normal in key muscle segments, and (3) a contiguous region of normal sensation starts at T2 (or S2). This work aims to characterize these cases and to discuss explanations. We analyzed 1330 early and late ISNCSCI assessments of 665 individuals from EMSCI. Forty-nine (3.6% of all 2660 MLs) MFSL (63.3% T1, 36.7% S1) and MFSF MLs from 34 individuals differed without consequences on ASIA Impairment Scale (AIS) grades (4 AIS A, 1 AIS B, 29 AIS D). In 16 AIS D cases, all testable motor functions were intact, with a mean Spinal Cord Independence Measure (SCIM) total score of 95.67 ± 3.51 in 3 individuals with MFSL-ML T1 and 100 in 5 individuals with MFSL-ML S1. The MFSF-MLs are on average 9.63 ± 7.50 (T1: 12.16 ± 8.43; S1: 5.28 ± 1.36) segments caudal to the sensory level (SL). We identified and characterized rare cases with an unusual sensory impairment pattern, which could be explained by an isolated damage of afferent spinal tracts or the presence of non-SCI conditions. Further investigations of these case are necessary for a more conclusive ML definition. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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