COMPARISON OF FUNCTIONAL AND MEDICAL ASSESSMENT IN THE CLASSIFICATIONOF PERSONS WITH SPINAL-CORD INJURY

For many reasons, persons with spinal cord injury (SCI) are classified according to a set of guidelines in which the term classification ref ers to a numeric value based on some selection of motor, sensory, and/ or functional tests. The resulting classification is used as a means o f quantifying the extent of neurological injury. Scales that focus on neurological injury (in the acute phase) differ from those that focus on functional ability (in the chronic phase). The relationship among t hese scales in grouping persons with SCI has not been ascertained. The purpose of the present study was to compare several classification sy stems within the same group of spinal cord injured subjects. Thirty su bjects with traumatic SCI were classified by the same examiner and gro uped according to three classification systems: 1) the American Spinal Injury Association (ASIA) Scale; 2) the Bracken Scale; and, 3) the wh eelchair basketball (BB) Sports Test. Calculation of Spearman's Rho co rrelation coefficients showed positive associations between the ASIA S cale and BB Sports Test (0.81). The Bracken Scale showed a negative co rrelation with the ASIA system (-0.66) and the BB Sports Test (-0.48). Of the three classification systems, the ASIA Scale showed the greate st discrimination in grouping subjects with SCI in both mixed (complet e and incomplete), as well as incomplete injuries. It was clear that t hese three systems could result in different patterns of subject group ing and thus might affect the outcome of the clinical research studies .