SUPERIORITY OF MOTOR LEVEL OVER SINGLE NEUROLOGICAL LEVEL IN CATEGORIZING TETRAPLEGIA

The purpose of this paper is to demonstrate the superiority of the Ame rican Spinal Injury Association motor level (ML) and upper extremity m otor score (UEMS) to the neurological level (NL) in determining self c are function in motor complete tetraplegia. Fifty subjects with trauma tic motor complete tetraplegia, NL C4-C8, were evaluated at admission and 12 months post injury. At both time periods NL, ML, and UEMS were determined. At 12 months, reported ability to perform six feeding acti vities of the Quadriplegia Index of Function (QIF) were documented. Sp earman correlations of the NL, BML, WML, UEMS, and feeding QIF scores were conducted, and results were compared with t tests for significant differences. Both the best and worst ML were more highly correlated t o the UEMS than was the NL (0.96 and 0.96 vs 0.66, P < 0.001). The bes t and worst ML were more highly correlated to the QIF feeding score th an was the NL (0.74 and 0.72 vs 0.56, P < 0.05). The UEMS had the high est correlation to the QIF feeding score, 0.78. These results suggest that the NL is an imprecise descriptor of the impairment in SCI, and i s therefore a poor predictor of the resultant disability. The ML and t he UEMS better reflect the severity of impairment and disability after motor complete tetraplegia.