AIM:
To assess sensory impairment using the ASIA sensory examination (examples C2 and C3 dermatomes)
Rationale:
The ASIA (American Spinal Injury Association) impairment scale is used to assess neurological level of sensory impairment
Equipment:
- Height adjustable bed
- Safety pin
- Cotton wool
- Sharps disposal container
Key Points:
General
- The patient is positioned in supine for the entire test
- The therapist demonstrates the procedure using a sensory intact point on the face
- The ASIA guidelines specify a single point to represent each dermatome- http://www.asia-spinalinjury.org/publications/2006_Classif_worksheet.pdf (Links to an external site.)
- Test both sides – test for light touch first – begin at C2 level on the right side and progress caudally, then begin at C2 level on the left side and progress caudally. Repeat for sharp/blunt.
- The sensory level is determined individually for each side of the body
- The sensory lesion is the lowest dermatome that is rated 2 for both light touch and sharp/blunt.
Light touch for each dermatome
- Using cotton wool, touch/don’t touch the point in random order and ask the question “Am I touching you?” If consistently incorrect, score 0. If consistently correct, compare sensation of light touch on face with the sensation of light touch on the point being tested and ask the question “Is this the same feeling as this?” If the patient answers yes, score 2. If the patient answers no, score 1.
Sharp/blunt for each dermatome
- Touch the point with the sharp/blunt end of the pin in random order and ask the question “Is this sharp or blunt?” If consistently incorrect, score 0. If consistently correct, compare the sharp sensation on face with the sharp sensation on the point being tested and ask the question “Is this the same feeling as this?” If the patient answers yes, score 2. If the patient answers no, score 1.
Common Errors:
- Therapist tests the entire dermatome instead of the specified point
- Therapist does not present stimuli in random fashion
Progression and Variety:
- Not applicable as these tests are performed in a standardized manner