Summary

A spinal cord injury (SCI) is a term used for any damage that occurs to the spinal cord or cauda equina. The American Spinal Injury Association (ASIA) has determined a functional impairment scale to describe an individual’s functional impairment after a SCI. Current literature and Neuro PT EDGE recommendations use the following classifications when describing psychometrics. AIS A is a motor complete SCI where no motor or sensory function is preserved below the level of the lesion or in the sacral segments. AIS B is a sensory incomplete spinal cord injury where sensation, but not motor function is preserved below the level of the lesion. The sacral segments are also preserved. AIS C is a motor incomplete SCI where function is preserved in the sacral segments or the individual meets the criteria for a sensory incomplete SCI and has some motor function below the level of the lesion. AIS D is a motor incomplete SCI with at least half of the key muscles below the level of injury having a grade greater than or equal to a 3. AIS E means that there is normal sensation and motor function at every spinal segment, and the individual is neurologically intact. A complete injury is determined by the absence of a voluntary anal contraction, sensory scores of 0 in S4-S5, and no response to deep anal pressure. An incomplete injury means that there is partial sensation and/or motor function in levels below the neurologic level of the injury, including S4-S5. Neuro PT EDGE considers an acute SCI 0-3 months after the incident, a subacute SCI 3-6 months after the incident, and a chronic SCI more than 6 months after the incident.

As the leading taskforce in recognition of these outcome measures, Neuro PT EDGE has ranked each outcome measure for use in regards to acuity of SCI and severity of SCI. A ranking of 4/4 indicates that the outcome measure is highly recommended with excellent psychometrics, and excellent clinical utility. A ranking of 3/4 indicates that the outcome measure is recommended with good psychometrics and good clinical utility. A 2/4 indicates that the test is reasonable to use, but the research group is limited. A ranking of 1 in 4 indicates that the outcome is not recommended because it has poor psychometrics and/or limited clinical utility.

Outcome Measures

Looking at neurologic diagnoses, the Academy of Neurologic Physical Therapy (ANPT) has developed recommendations for the use of outcome measures in clinical practice and research. The Academy has also developed reference pages for the outcome measures that must be learned throughout a 3-year DPT program. Of the core outcome measures, five of the six will have SCI specific psychometrics listed on their pages. These links can be found on the home page of the website. No research has been done with the 5xSTS in the SCI population, so there will be no information on that tab. The outcome measures listed below are recommended tests that entry-level physical therapists should be able to administer. These were reviewed by Neuro PT EDGE and were found to be useful for the SCI population. There are other outcome measures on this document that are supported for use with the SCI population; however, they were not categorized as entry-level.

SCI EDGE Outcome Measures Summary

SCI EDGE Complete Document of Recommendations