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ASIA Impairment Scale

&

Expected Functional Level Of Spinal Cord Disruption

 

ASIA IMPAIRMENT SCALE Expected Functional Level Vertebral Diagrams

 


 

Expected Functional Level Of Spinal Cord Disruption
  Quadriplegia

C1-C3

Vagus domination of heart, respiration, blood vessels, all organs below injury.

Movement in neck and above, loss of innervation to diaphragm, absence of independent respiratory function.

Ability to drive power wheelchair equipped with portable respirator by using chin control or sip and puff, lack of bowel and bladder control.

C4

Vagus domination of heart, respiration, and all vessels and organs below injury.

Sensation and movement above neck.

Ability to drive power chair using chin control or sip and puff, lack of bowel and bladder control.

C5

Vagus domination of heart, respiration, and all vessels and organs below injury.

Full neck, partial shoulder, back, biceps; gross elbow, inability to roll over or use hands; decreased respiratory reserve.

Ability to drive power chair with mobile hand supports, ability to use hand splints (in some clients), lack of bowel and bladder control.

C6

Vagus domination of heart, respiration, and all vessels and organs below injury.

Shoulder and upper back abduction and rotation at shoulder, full biceps to elbow flexion, wrist extension, weak grasp of thumb, decreased respiratory reserve.

Ability to assist with transfer and perform some self-care, feed self with hand devices, push wheelchair on smooth, flat surface; lack of bowel and bladder control.

C7

Vagus domination of heart, respiration, and all vessels and organs below injury.

All triceps to elbow extension, finger extensors and flexors, good grasp with some decreased strength, decreased respiratory reserve.

Ability to transfer self to wheelchair, roll over and sit up in bed, push self on most surfaces, perform most self-care; independent use of wheelchair; ability to drive car with hand controls (in some clients); lack of bowel and bladder control.

Paraplegia

T1-T6

Sympathetic innervation to heart, vagus domination of the rest.

Full innervation of upper extremities, back, essential intrinsic muscles of hands; full strength and dexterity of grasp; decreased trunk stability; decreased respiratory reserve.

Full independence in self-care and in wheelchair, ability to drive car with hand controls (in most clients), ability to use full body brace for exercise but not for functional ambulation, lack of bowel and bladder control.

T6-T12

Vagus domination only of leg vessels, gastrointestinal and genitourinary organs.

Full, stable thoracic muscles and upper back; functional intercostals, resulting in increased respiratory reserve.

Full independent use of wheelchair; ability to stand erect with full body brace, ambulate on crutches with swing (though gait is difficult); inability to climb stairs; lack of bowel and bladder control.

L1-L2

Vagus domination of leg muscles.

Varying control of legs and pelvis, instability of lower back.

Good sitting balance, full use of wheelchair.

L3-L4

Partial domination of leg vessels, gastrointestinal and genitourinary organs.

Quadriceps and hip flexors, absence of hamstring function, flail ankles.

Completely independent ambulation with short leg braces and canes, inability to stand for long periods, bladder and bowel continence.

This is a list of the EXPECTED functional level of spinal cord disruption and rehabilitation potential. Injuries are not all the same...and functional levels will differ. Some will be able to do more than what is listed here...some will have less ability. This is only to give an idea of what might be expected functionally of someone with an injury at one of these levels. C1-C7 means an injury has occurred between the first and seventh cervical vertebrae. T1-T12 means the injury has occurred between the first and twelfth thoracic vertebrae. L1-L4 means there is an injury between the first and fourth lumbar vertebrae.

 

 

ASIA IMPAIRMENT SCALE ~ Expected Functional Level ~ Vertebral Diagrams
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ASIA IMPAIRMENT SCALE
  A = Complete: No motor or sensory function is preserved in the sacral segments S4-S5.

B = Incomplete: Sensory but not motor function is preserved below the neurological level and includes the sacral segments S4-S5.

C = Incomplete: Motor function is preserved below the neurological level, and more than half of key muscles below the neurological level have a muscle grade less than 3.

D = Incomplete: Motor function is preserved below the neurological level, and at least half of key muscles below the neurological level have a muscle grade of 3 or more.

E = Normal: Motor and sensory function is normal.

 
Standard Neurological Classification of Spinal Cord Injury

 

ASIA IMPAIRMENT SCALE ~ Expected Functional Level ~ Vertebral Diagrams
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Back & Neck Care Guide

Spinal cord injury: Spinal cord 101

 

ASIA IMPAIRMENT SCALE ~ Expected Functional Level ~ Vertebral Diagrams
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Top Home   Date Last Edited 07/30/2009
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