ASIA impairment scale
Dr Frank Gaillard et al.
The American Spinal Injury Association impairment scale is part of the ASIA spinal cord injury classification. It divides spinal cord injuries into 5 categories, with optional clinical syndromes.
- A - complete
- 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 strength
- 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 strength
- E - normal
Optional clinical syndromes
- central cord syndrome
- Brown-Sequard syndrome
- anterior cord syndrome
- conus medullaris compression syndrome
- cauda equina compression syndrome
Muscle strength grading
- 0 - total paralysis
- 1 - palpable or visible contraction
- 2 - active movement, full range of motion, gravity eliminated
- 3 - active movement, full range of motion, against gravity
- 4 - active movement, full range of motion, against gravity and provides some resistance
- 5 - active movement, full range of motion, against gravity and provides normal resistance
- 5* - muscle able to exert, in examiner’s judgement, sufficient resistance to be considered normal if identifiable inhibiting factors were not present

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