Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064203%3A_____%2F25%3A10501054" target="_blank" >RIV/00064203:_____/25:10501054 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00216208:11130/25:10501054

Výsledek na webu

<a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=NIlIH-tv2N" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=NIlIH-tv2N</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.46292/sci24-00094" target="_blank" >10.46292/sci24-00094</a>

Jazyk výsledku

angličtina

Název v původním jazyce

Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes

Popis výsledku v původním jazyce

BACKGROUND: In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), two approaches for determining motor levels (MLs) in not clinically testable myotomes (C2-C4, T2-L1, S2-S5) are described: one where the motor level follows the sensory level (MFSL) and another deriving motor function from sensory function (MFSF). Their results differ when (1) all key muscles of an upper (or upper and lower) extremity are scored as intact, (2) sensation is not normal in key muscle segments, and (3) a contiguous region of normal sensation starts at T2 (or S2). OBJECTIVES: This work aims to characterize these cases and to discuss explanations. METHODS: We analyzed 1330 early and late ISNCSCI assessments of 665 individuals from EMSCI. RESULTS: Forty-nine (3.6% of all 2660 MLs) MFSL (63.3% T1, 36.7% S1) and MFSF MLs from 34 individuals differed without consequences on ASIA Impairment Scale (AIS) grades (4 AIS A, 1 AIS B, 29 AIS D). In 16 AIS D cases, all testable motor functions were intact, with a mean Spinal Cord Independence Measure (SCIM) total score of 95.67 +- 3.51 in 3 individuals with MFSL-ML T1 and 100 in 5 individuals with MFSL-ML S1. The MFSF-MLs are on average 9.63 +- 7.50 (T1: 12.16 +- 8.43; S1: 5.28 +- 1.36) segments caudal to the sensory level (SL). CONCLUSION: We identified and characterized rare cases with an unusual sensory impairment pattern, which could be explained by an isolated damage of afferent spinal tracts or the presence of non-SCI conditions. Further investigations of these case are necessary for a more conclusive ML definition.

Název v anglickém jazyce

Clarifications of the Motor Level Definition in the International Standards for Neurological Classification of Spinal Cord Injury in Not Clinically Testable Myotomes

Popis výsledku anglicky

BACKGROUND: In the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), two approaches for determining motor levels (MLs) in not clinically testable myotomes (C2-C4, T2-L1, S2-S5) are described: one where the motor level follows the sensory level (MFSL) and another deriving motor function from sensory function (MFSF). Their results differ when (1) all key muscles of an upper (or upper and lower) extremity are scored as intact, (2) sensation is not normal in key muscle segments, and (3) a contiguous region of normal sensation starts at T2 (or S2). OBJECTIVES: This work aims to characterize these cases and to discuss explanations. METHODS: We analyzed 1330 early and late ISNCSCI assessments of 665 individuals from EMSCI. RESULTS: Forty-nine (3.6% of all 2660 MLs) MFSL (63.3% T1, 36.7% S1) and MFSF MLs from 34 individuals differed without consequences on ASIA Impairment Scale (AIS) grades (4 AIS A, 1 AIS B, 29 AIS D). In 16 AIS D cases, all testable motor functions were intact, with a mean Spinal Cord Independence Measure (SCIM) total score of 95.67 +- 3.51 in 3 individuals with MFSL-ML T1 and 100 in 5 individuals with MFSL-ML S1. The MFSF-MLs are on average 9.63 +- 7.50 (T1: 12.16 +- 8.43; S1: 5.28 +- 1.36) segments caudal to the sensory level (SL). CONCLUSION: We identified and characterized rare cases with an unusual sensory impairment pattern, which could be explained by an isolated damage of afferent spinal tracts or the presence of non-SCI conditions. Further investigations of these case are necessary for a more conclusive ML definition.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30306 - Sport and fitness sciences

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2025

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Topics in Spinal Cord Injury Rehabilitation

ISSN

1082-0744

e-ISSN

1945-5763

Svazek periodika

31

Číslo periodika v rámci svazku

3

Stát vydavatele periodika

US - Spojené státy americké

Počet stran výsledku

11

Strana od-do

37-47

Kód UT WoS článku

001561548400003

EID výsledku v databázi Scopus

2-s2.0-105015005367