A TEST OF THE 1992 INTERNATIONAL STANDARDS FOR NEUROLOGICAL AND FUNCTIONAL CLASSIFICATION OF SPINAL-CORD INJURY

This study was designed to test the 1992 International Standards for N eurological and Functional Classification of Spinal Cord Injury, One h undred and six professionals in the field of spinal cord injury attend ing an instructional course at the 1994 ASIA Meeting participated in t he test. Participants completed a pretest and posttest in which they c lassified two patients who had a spinal cord injury (one with complete tetraplegia and one with incomplete paraplegia) by sensory and motor levels, zone of partial preservation (ZPP), ASIA Impairment Scale and completeness of injury. Between tests, three members of the ASIA Stand ards Executive Committee gave presentations on the neurological assess ment, scoring, scaling and classification of spinal cord injury and a video of the actual examinations of the two cases was viewed. Percent 'correct' las defined by the ASIA Standards Committee) was calculated for sensory and motor levels, ZPP, ASIA Impairment and completeness. O verall, the analyses showed that participants had very little difficul ty in correctly classifying the patient with complete tetraplegia. Pre tests scores ranged from 72% (left motor level) to 96% (complete injur y), posttest scores from 73% (left motor level to 100% correct (comple te injury). For the % patient with incomplete paraplegia (Case 2), sco res were considerably lower. Pretest scores ranged from 16% (right mot or level) to 95% correct (incomplete injury); posttest scores from 21% (right motor level) to 97% correct (incomplete injury), The results s howed that further revisions of the 1992 Standards and more training i s needed to ensure accurate classification of spinal cord injury.